Postby Rock_Robster » Wed Sep 22, 2021 9:07 am
Very interesting - thanks for sharing this. I’d tend to be careful with interpreting these, as it wasn’t a randomised controlled trial. The allocation of patients into the groups wasn’t done randomly, but instead based on clinical treatment decisions made by the oncologists at the time, which is highly likely to be confounded by a number of other factors (eg generally healthier/younger/stronger patients are more likely to be given oxaliplatin, compared to older patients or those with multiple comorbidities). Or conversely doctors may be more likely to prescribe oxy where they think a patient is at greater risk of recurrence/progression, partially explaining why oxaliplatin patients overall didn’t appear to do better.
While they’ve attempted to correct for this in the statistical analysis, unfortunately this type of trial still struggles to show more than correlation (ie I would be very hesitant to withhold oxaliplatin from any particular stage III patient without multiple RCTs. The difficulty here could be ethics, if FOLFOX is accepted as standard of care).
41M Australia
2018 Dx RC
G2 EMVI LVI, 4 liver mets
pT3N1aM1a Stage IVa MSS NRAS G13R
CEA 14>2>32>16>19>30>140>70
11/18 FOLFOX
3/19 Liver resection
5/19 Pelvic IMRT
7/19 ULAR
8/19 Liver met
8/19 FOLFOX, FOLFOXIRI, FOLFIRI
12/19 Liver resection
NED 2 years
11/21 Liver met, PALN, lung nodules
3/22 PVE, lymphadenectomy, liver SBRT
10/22 PALN SBRT
11/22 Liver mets, peri nodule. Xeloda+Bev
4/23 XELIRI+Bev
9/23 ATRIUM trial
12/23 Modified FOLFIRI+Bev
3/24 VAXINIA (CF33 + hNIS) trial