Most Read Articles
Natalia Reoutova, 4 days ago

A retrospective analysis of seven clinical trials demonstrated that neratinib-based therapy is safe and effective in Asian patients with metastatic HER2-positive breast cancer.

Christina Lau, 14 Feb 2019
Progress in the treatment of rare cancers has been named Advance of the Year by the American Society of Clinical Oncology (ASCO).
Pearl Toh, 28 Aug 2019
The addition of radium-223 (Ra223) to enzalutamide for the treatment of mCRPC* was associated with increased fracture risk, which was entirely abolished with mandated use of bone-protecting agents (BPAs) such as zoledronic acid and denosumab, according to interim results of the EORTC 1333 (PEACE III) trial.
Audrey Abella, 28 Aug 2019
A pooled analysis of six trials failed to show noninferiority of a 3-month regimen to a 6-month regimen of oxaliplatin-based chemotherapy for patients with high-risk, stage II colorectal cancer (CRC).

Oxaliplatin-based chemo for stage II CRC: Shorter regimen better?

Audrey Abella
28 Aug 2019

A pooled analysis of six trials failed to show noninferiority of a 3-month regimen to a 6-month regimen of oxaliplatin-based chemotherapy for patients with high-risk, stage II colorectal cancer (CRC).

The 5-year disease-free survival (DFS) rates were 80.7 percent in the 3-month arm and 83.9 percent in the 6-month arm, yielding an absolute difference of 3.2 percent and a hazard ratio (HR) of 1.17 (80 percent confidence interval [CI], 1.05–1.31). “[Based on] the forest plot, the upper limit of the CI crosses the noninferiority margin of 1.2. Hence, we cannot conclude that 3 months of treatment is noninferior to 6 months,” said Dr Dawn Chong from the National Cancer Centre Singapore who presented the findings at BASCO 2019.

“However, the 3-month treatment regimen led to less toxicities,” said Chong, citing the significantly lower overall adverse event (AE) rates in the 3-month vs the 6-month arm (60 percent vs 82 percent; p<0.0001), particularly the incidences of neurotoxicity (13 percent vs 36 percent; p<0.0001) and diarrhoea (12 percent vs 19 percent; p=0.0002).

Investigators from the IDEA* collaboration prospectively pooled results from six randomized phase III trials evaluating the duration of adjuvant oxaliplatin-based chemotherapy in CRC, of which four** included individuals with high-risk stage II disease (n=3,332, median age 64.2 years, 56.5 percent male). Participants had been randomized 1:1 to receive either 3 or 6 months of a CAPOX*** or FOLFOX# regimen. Median follow-up ranged from >2 years to >5 years. [BASCO 2019, abstract 3501]

 

CAPOX over FOLFOX?

When stratified according to regimen, the 5-year DFS rates among patients in the FOLFOX arm who received the 3-month regimen were lower than that of those who received the 6-month regimen (79.2 percent vs 86.5 percent), generating an absolute difference of 7.3 percent. “[This] strongly suggests inferiority of the 3-month FOLFOX regimen to the 6-month regimen,” said Chong. However, the 3-month regimen was less toxic than the 6-month regimen as evidenced by the lower AE rates (64 percent vs 87 percent; p<0.0001).

The 5-year DFS rates were similar in CAPOX recipients who received the regimen for 3 and 6 months (81.7 percent and 82 percent, respectively), suggesting that the shorter CAPOX regimen is as good as the longer one. As in FOLFOX, the 3-month regimen was also less toxic than the 6-month regimen (57 percent vs 79 percent; p<0.0001).

“[As some of] our data suggested the noninferiority of 3-month CAPOX to a 6-month regimen … we can offer this option to selected stage II CRC patients with high-risk features,” said Chong. “[However, as] IDEA did not compare FOLFOX and CAPOX … we cannot compare these regimens,” she added.

 

 

Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Oncology - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
Natalia Reoutova, 4 days ago

A retrospective analysis of seven clinical trials demonstrated that neratinib-based therapy is safe and effective in Asian patients with metastatic HER2-positive breast cancer.

Christina Lau, 14 Feb 2019
Progress in the treatment of rare cancers has been named Advance of the Year by the American Society of Clinical Oncology (ASCO).
Pearl Toh, 28 Aug 2019
The addition of radium-223 (Ra223) to enzalutamide for the treatment of mCRPC* was associated with increased fracture risk, which was entirely abolished with mandated use of bone-protecting agents (BPAs) such as zoledronic acid and denosumab, according to interim results of the EORTC 1333 (PEACE III) trial.
Audrey Abella, 28 Aug 2019
A pooled analysis of six trials failed to show noninferiority of a 3-month regimen to a 6-month regimen of oxaliplatin-based chemotherapy for patients with high-risk, stage II colorectal cancer (CRC).