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Adjuvant oxaliplatin reduces colon cancer recurrence, deaths

Monday, January 25, 2016

Photo of Manish Shah, M.D. Adding oxaliplatin to fluoropyrimidine-based adjuvant chemotherapy significantly reduces the risk of recurrence of colon cancer, suggests an analysis of pooled data from five modern adjuvant therapy trials, published Jan. 25 in the Journal of Clinical Oncology.

Among more than 12,000 patients enrolled in the randomized clinical trials, the addition of oxaliplatin to standard adjuvant chemotherapy with fluorouracil (FU) and leucovorin was associated with significant reductions in the risk of recurrence within the first 14 months following treatment in patients with stage II colon cancer, and within the first 4 years for patients with stage III disease, reports Manish A. Shah, M.D., Bartlett Family Associate Professor of Medicine and co-director of the Center for Advanced Digestive Care.

The authors looked at pooled data from five randomized studies with oxaliplatin for which mature data are available: the NSABP C-07 (National Surgical Adjuvant Breast and Bowel Project) trial, the NSABP C-08, theN0147MOSAIC (Multicenter International Study of Oxaliplatin/ 5FU-LV in the Adjuvant Treatment of Colon Cancer), and XELOXA (Adjuvant XELOX).

“[W]e found that oxaliplatin significantly reduces the risk of recurrence and death within the first 6 years post treatment, with the greatest benefit observed in patients with higher-risk cancers. The time course risk of recurrence for stage II colon cancer is significantly reduced compared with patients with stage III disease, with potential implications for surveillance strategies,” they wrote.

They plotted continuous-time hazards of recurrence and death from the time of randomization up to 6 years in all patients treated with oxaliplatin and in those randomized to FU/leucovorin with or without oxaliplatin.

They found that for patients treated with FU, leucovorin, and oxaliplatin, the maximum hazard for recurrence occurred at around 14 months post treatment, and then dwindled to nearly zero after about 6 years of follow-up. They also found that the risk of recurrence was lower with the addition of oxaliplatin at all-time points.

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This is an excerpt of a story that first appeared on the Oncology Practice Digital Network. Read the full article here.