A study of more than 12,800 patients with stage III colon cancer in 12 countries found that some people with colon cancer only need half of the 6-month standard course of chemo after surgery. Below is the news release.
It's interesting that CAPOX showed slightly better results at stopping recurrence since there are still oncs out there who are dubious about Xeloda!
For some with colon cancer, shorter chemotherapy is nearly as effective and has fewer side effects
A large international study has found that some people with colon cancer may only need to have half of the 6-month standard course of chemotherapy after surgery. The study found that there was only a 1% overall difference between people who had a cancer recurrence after 6 months and 3 months of chemotherapy. A recurrence means the cancer returned after the initial treatment period.
Chemotherapy lowers the chance of recurrence after colon cancer surgery, and this kind of treatment is called adjuvant chemotherapy. Since 2004, standard adjuvant chemotherapy has required 6 months of a combination of chemotherapies. There were 2 adjuvant chemotherapy combinations included in this analysis, called FOLFOX and CAPOX.
This study included data from more than 12,800 patients with stage III colon cancer in 6 different phase III clinical trials in 12 countries. Participants’ health was tracked for a median time of 39 months after treatment. The median is the midpoint, so half were followed for less than 39 months and the other half were followed for more than 39 months. For all patients combined, the rate of disease-free survival at 3 years was very similar for both 3 months and 6 months of chemotherapy (74.6% vs. 75.5%). Disease-free survival is the amount of time after treatment during which no sign of cancer is found.
For each chemotherapy combination, there were small differences in the 3-year disease-free survival rates for the 3-month and 6-month treatment periods. With the FOLFOX combination, the 3-month treatment was very close to the 6-month treatment at stopping recurrence (73.6% vs. 76.0%). If patients received CAPOX, the 3-month and 6-month treatments were nearly the same at stopping recurrence (75.9% vs. 74.8%).
People with lower risk colon cancer had almost the same rates of recurrence if they took 3 or 6 months of chemotherapy (83.1% vs 83.3%, respectively). Lower risk colon cancer was defined as cancer that had spread to 1 to 3 lymph nodes and not completely through the bowel wall.
The shorter course also resulted in fewer side effects. Both FOLFOX and CAPOX include oxaliplatin (Eloxatin). Oxaliplatin can cause nerve damage, which leads to permanent numbness, tingling, and pain. The longer someone receives oxaliplatin, the higher the risk of long-term nerve damage. Specifically, this study found that the shorter course of chemotherapy had substantially lower rates of severe nerve damage for both FOLFOX (15% vs. 45%) and CAPOX (17% vs. 48%).
What does this mean? For some people after colon cancer surgery, a 3-month course of combination chemotherapy could reduce the risk of recurrence and the chances of long-term side effects. This approach may offer a better quality of life.
“Our findings could apply to about 400,000 colon cancer patients worldwide every year. For 60% of these patients, who have lower risk for cancer recurrence, 3 months of chemotherapy will likely become the new standard of care. Patients with higher risk colon cancer, however, should discuss these results with their doctor to see if a shorter course of therapy would be right for them.”
— senior study author Axel Grothey, MD
Mayo Clinic Cancer Center
Rochester, Minnesota