Clinical Edge Journal Scan

Effect of early treatment and oxaliplatin discontinuation in patients with stage III colon cancer


 

Key clinical point: Patients with stage III colon cancer (CC) who received >50% of the planned 6-month oxaliplatin-based chemotherapy may discontinue oxaliplatin and continue fluoropyrimidine in case of clinically relevant neurotoxicity.

Major finding: Discontinuation of all treatment (DT) vs no DT was independently associated with worse 3-year disease-free survival (DFS, adjusted hazard ratio [aHR] 1.61; P < .001) and 5-year overall survival (OS aHR, 1.73; P < .001), but discontinuation of oxaliplatin had no effect on 3-year DFS ( P = .3) and 5-year OS ( P = .1). However, patients receiving <50% vs 100% of the planned oxaliplatin cycles had poorer DFS (aHR 1.34; 95% CI 1.10-1.64) and OS (aHR 1.61; 95% CI 1.29-2.01).

Study details: This pooled analysis of 11 adjuvant trials included patients with stage III CC who were to receive 6 months of infusional fluorouracil+leucovorin+oxaliplatin or capecitabine+oxaliplatin.

Disclosures: No funding source was declared. Some authors declared employment, stock, or other ownership interest in or receiving research support, speakers' fee, or consultancy fees from various sources.

Source: Gallois C et al. Prognostic impact of early treatment and oxaliplatin discontinuation in patients with stage III colon cancer: An ACCENT/IDEA pooled analysis of 11 adjuvant trials. J Clin Oncol. 2022 (Oct 28). Doi: 10.1200/JCO.21.02726

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