Benefit of Oxaliplatin in Stage III Colon Cancer According to IDEA Risk Groups: Findings from the ACCENT Database of 4934 Patients
| Autor: | Hans-Joachim Schmoll, Aimery de Gramont, Norman Wolmark, Greg Yothers, Einat Shacham-Shmueli, Ofer Margalit, Qian Shi, André Thierry, Daniel G. Haller, Manel Rakez, Ben Boursi |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male Oncology medicine.medical_specialty Time Factors Organoplatinum Compounds Colorectal cancer medicine.medical_treatment Leucovorin Disease Disease-Free Survival 03 medical and health sciences 0302 clinical medicine Risk groups Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans Aged Neoplasm Staging business.industry Proportional hazards model Hazard ratio Gastroenterology Middle Aged medicine.disease digestive system diseases Oxaliplatin Chemotherapy Adjuvant Fluorouracil 030220 oncology & carcinogenesis Colonic Neoplasms 030211 gastroenterology & hepatology business Adjuvant Follow-Up Studies medicine.drug |
| Zdroj: | Clinical Colorectal Cancer. 20:130-136 |
| ISSN: | 1533-0028 |
| DOI: | 10.1016/j.clcc.2021.02.001 |
| Popis: | Background The International Duration Evaluation of Adjuvant Chemotherapy (IDEA) pooled analysis compared 3 to 6 months of adjuvant chemotherapy for stage III colon cancer. Patients were classified into low risk and high risk, suggesting low-risk patients may be offered only 3 months of treatment. In this study, we aimed to assess the benefit of oxaliplatin in the adjuvant setting per IDEA risk groups, using data from 3 large adjuvant phase III studies, namely Multicenter International Study of Oxaliplatin/Fluorouracil/ Leucovorin in the Adjuvant Treatment of Colon Cancer (MOSAIC), C-07, and XELOXA. Methods Using the MOSAIC, C-07, and XELOXA previously published studies, we identified 2810 low-risk and 2124 high-risk patients with stage III colon cancer. We used Cox regression model to evaluate the magnitude of survival differences between IDEA risk groups, according to oxaliplatin use. Based on design similarity and equivalent follow-up data, MOSAIC and C-07 were pooled, whereas XELOXA was analyzed separately. Subgroup analyses were also performed for T4 and/or N2 patients. Results Individuals with IDEA low and high risk derived overall survival benefit from the addition of oxaliplatin to adjuvant chemotherapy, with adjusted hazard ratios of 0.79 (0.66-0.95) and 0.84 (0.71-0.99), respectively. Among individuals with IDEA high risk, those with T4 disease did not gain overall survival benefit from addition of oxaliplatin with hazard ratio of 0.95 (0.71-1.27). Similar results were demonstrated using data from the XELOXA study. Conclusion IDEA risk classification per se does not predict benefit from addition of oxaliplatin to adjuvant chemotherapy in stage III colon cancer. T4 disease may predict lack of benefit from oxaliplatin addition. |
| Databáze: | OpenAIRE |
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