вЂњThis generated a lot of debate over the clinical interpretation of these data considering the huge reduction in toxicity afforded by the 3-month duration. The overall incidence of grade 3/4 toxicities was also lower with the shorter duration of chemotherapy, whether it be CAPOX (24% vs. With regard to safety, the incidence of grade 2 to 4 neurotoxicity was three times lower with 3 versus 6 months of adjuvant chemotherapy regardless of whether patients received CAPOX (15% vs. 1 However, the upper limit of the HR confidence interval exceeded the predefined margin of 1.12, thus failing to meet the statistical assumptions for noninferiority. Results of the primary endpoint analysis reported 2 years ago showed a marginal 0.9% decrease in 3-year DFS with 3 versus 6 months of CAPOX or FOLFOX (HR 1.07, 95% CI ). To test this hypothesis within a noninferiority study, the IDEA investigators elected to prospectively pool data from six clinical trials-TOSCA, SCOT, IDEA FRANCE, ACHIEVE, HORG, and CALGB SWOG 80702-to obtain the large number of patients required to reliably evaluate the findings. The IDEA collaboration took root from the notion that a shorter duration of adjuvant oxaliplatin- based chemotherapy might prove equally efficacious and less toxic than the typical 6-month course. Unfortunately, these benefits come with a heavy toxicity burden in the form of cumulative persistent neurotoxicity from the oxaliplatin component. Christopher LieuДЄdministering oxaliplatin and a fluoropyrimidine for 6 months after surgery has been standard practice in patients with stage III colon cancer since 2004, owing to improved disease-free survival (DFS) and OS. Sobrero, MD, of the Ospedale San Martino IRCCS, Genova, Italy, summarizing the IDEA findings. For those unwilling to lose even 1% to 2% of efficacy, 6 months of therapy is recommended,вЂќ said Alberto F. For the majority of these, risk-benefit assessment suggests 3 months of CAPOX as well. вЂњThe implications for clinical practice are that 60% of patients with stage III colon cancer are low risk and should receive 3 months of CAPOX.

In contrast, the shorter treatment course produces much less toxicity, particularly neurotoxicity, than the standard 6-month course. Prospective evaluation of nearly 13,000 individuals with stage III colon cancer found minimal difference in 5-year overall survival (OS) with 3 versus 6 months of adjuvant CAPOX or FOLFOX for the majority of patients, according to the final results of the International Duration Evaluation of Adjuvant Chemotherapy (IDEA) collaboration ( Abstract 4004).

Magic trail cross trial colon cancer