Some stage III colorectal cancer may only need three months of chemotherapy — 5 study insights

A study, presented at the American Society of Clinical Oncology Annual Meeting, examined if researchers could reduce chemotherapy from six months to three months when treating stage III colorectal cancer patients.

Anthony F. Shields, MD, associate director of Detroit-based Barbara Ann Karmanos Cancer Institute, and colleagues conducted a prospective, pre-planned pooled analysis of six concurrent phase III clinical trials with 12,834 patients from 12 counties.

They examined the efficacy of three-month chemotherapy treatments compared to six-month treatments.

Researchers measured disease-free survival rates.

Here's what they found:

1. Forty percent of the patients received Xelox chemotherapy.

2. G3+ neurotoxicity was higher in the six-month group than the three-month group.

3. The median follow-up rate was 39 months, researchers observed 3,262 disease-free survival events.

4. At three years the disease-free survival rate was 74.6 percent for the three-month group and 75.5 percent for the six-month group. Researchers estimated the disease-free survival hazard rate at 1.07. The actual rates were 1.16 for Folfox chemotherapy and 0.95 for Xelox.

5. The three month-treatment patients had a less than 1 percent lower risk of recurrence compared with those on a six-month treatment course, measured by three-year disease-free survival rate.

Researchers concluded, "While [non-inferiority] was not established for the overall cohort, NI of 3m v 6m oxali-based adjuvant therapy was supported for Xelox. As each IDEA trial treated varying proportions of patients with Xelox (0 to 75 percent), the regimen interaction likely produced the differential outcomes observed between individual studies."

The researchers believe the data provides a framework for the use of individualized adjuvant therapies. They also believe approximately 60 percent of Americans with low-risk colorectal cancer could achieve the same benefits six months of chemotherapy produces in three.

ASCO's annual meeting took place June 2 to June 6 in Chicago.

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