Top

Published in:

01-04-2010 | Colorectal Cancer

Adjuvant Therapy for Colon Cancer: Learning from the Past to Inform the Future

Authors: Daniel Sargent, PhD, Axel Grothey, MD

Published in: Annals of Surgical Oncology | Issue 4/2010

Excerpt

Adjuvant treatment of colon cancer has been a clear success story over the last three decades. Since the seminal trial of Moertel demonstrating the efficacy of 5-fluorouracil (5-FU) with levamisole for stage III disease, to the current standard of care of oxaliplatin plus fluoropyrimidines delivered either as the FOLFOX or the XELOX regimen, a large number of randomized clinical trials have supported incremental advances in efficacy as well as modifications to retain efficacy while reducing toxicity and/or duration of therapy.1‐3 The Colon Clinical Trials Program of the National Surgical Adjuvant Breast and Bowel Project (NSABP) has been a fundamental cog in this wheel; many of the NSABP’s trials have helped set or validate a standard of care. As such, it is useful to review the history of the NSABP’s trial program, which Wilkinson et al. do in this issue.4 …

Moertel CG, Fleming TR, Macdonald JS, et al. Levamisole and fluorouracil for adjuvant therapy of resected colon carcinoma. N Engl J Med. 1990;322:352–58.PubMedCrossRef

André T, Boni C, Mounedji-Boudiaf L, et al. Oxaliplatin, 5-fluorouracil, and leucovorin as adjuvant treatment for colon cancer. N Engl J Med. 2004;350:2343–51.CrossRefPubMed

Haller D, Tabernero J, Maroun J, de Braud F, Price T, Van Cutsem E, et al. First efficacy findings from a randomized phase III trial of capecitabine + oxaliplatin vs. bolus 5-FU/LV for stage III colon cancer (NO16968/XELOXA study). Eur J Cancer Suppl. 7(3)3:4

Wilkinson NW, Yothers G, Lopa S, Costantino JP, Petrelli NJ, Wolmark N. Long-term survival results of surgery alone versus surgery plus 5-fluorouracil and leucovorin for stage II and stage III colon cancer: pooled analysis of NSABP C-01 through C-05. A baseline from which to compare modern adjuvant trials. Ann Surg Oncol. 2010; doi:10.1245/s10434-009-0881-y.

NIH consensus conference. Adjuvant therapy for patients with colon and rectal cancer. JAMA. Sep 19 1990;264(11):1444–50.

Jessup JM, Stewart A, Greene FL, Minsky BD. Adjuvant chemotherapy for stage III colon cancer: implications of race/ethnicity, age, and differentiation. JAMA. 2005;294(21):2703–11.CrossRefPubMed

Sargent DJ, Goldberg RM, Jacobson SD, Macdonald JS, Labianca R, Haller DG, et al. A pooled analysis of adjuvant chemotherapy for resected colon cancer in elderly patients. N Engl J Med. 2001;345(15):1091–97. PMID:11596588.CrossRefPubMed

Sargent DJ, Sobrero A, Grothey A, O’Connell MJ, Buyse M, Andre T, et al. Evidence for cure by adjuvant therapy in colon cancer: Observations based on individual patient data from 20,898 patients on 18 randomized trials. J Clin Oncol. 2009;27(6):872–7.CrossRefPubMed

Sargent DJ, Patiyil S, Yothers G, Haller DG, Gray R, Benedetti J, et al. End points for colon cancer adjuvant trials: Observations and recommendations based on individual patient data from 20,898 patients enrolled onto 18 randomized trials from the ACCENT Group. J Clin Oncol. 2007;25(29):4569–74.CrossRefPubMed

10.

Sargent DJ, Yothers G, Van Cutsem E, Cassidy J, Saltz L, Wolmark N, et al., The Adjuvant Colon Cancer Endpoints (ACCENT) Group. Use of two-year disease-free survival (DFS) as a primary endpoint in stage III adjuvant colon cancer trials with fluoropyrimidines with or without oxaliplatin or irinotecan: New data from 12,676 patients from MOSAIC, X-ACT, PETACC-3, NSAPB C-06 and C-07, and C89803. J Clin Oncol. 2009;27:15s, (suppl; abstr 4011).

11.

Andre T, Boni C, Navarro M, Tabernero J, Hickish T, Topham C, et al. Improved overall survival with oxaliplatin, fluorouracil, and leucovorin as adjuvant treatment in stage II or III colon cancer in the MOSAIC trial. J Clin Oncol. 2009;27(19):3109–16.CrossRefPubMed

12.

Wolmark N, Wieand S, Kuebler PJ, Colangelo L, O’Connell MJ, Yothers G. A phase III trial comparing FULV to FULV + oxaliplatin in stage II or III carcinoma of the colon: Survival results of NSABP Protocol C-07. J Clin Oncol. 2008;26:(May 20 suppl; abstr LBA4005).

13.

Wolmark N, Yothers G, O’Connell MJ, Sharif S, Atkins JN, Seay TE, et al. A phase III trial comparing mFOLFOX6 to mFOLFOX6 plus bevacizumab in stage II or III carcinoma of the colon: Results of NSABP Protocol C-08. J Clin Oncol. 2009;27:18s, (suppl; abstr LBA4).

14.

Mamounas E, Wieand S, Wolmark N, et al. Comparative efficacy of adjuvant chemotherapy in patients with Dukes’ B versus Dukes’ C colon cancer: Results from four National Surgical Adjuvant Breast and Bowel Project adjuvant studies (C-01, C-02, C-03, and C-04). J Clin Oncol. 1995;17:1349–55.

15.

IMPACT Investigators. Efficacy of adjuvant fluorouracil and folinic acid in colon cancer. Lancet. 1995;345:939–44.CrossRef

16.

Quasar Collaborative Group, Gray R, Barnwell J, McConkey C, Hills RK, Williams NS, Kerr DJ. Adjuvant chemotherapy versus observation in patients with colorectal cancer: a randomised study. Lancet. 2007;370(9604):2020–29.CrossRefPubMed

17.

Kerr D, Gray R, Quirke P, Watson D, Yothers G, Lavery IC, et al., Quasar Colon Teams. A quantitative multigene RT-PCR assay for prediction of recurrence in stage II colon cancer: Selection of the genes in four large studies and results of the independent, prospectively designed QUASAR validation study. J Clin Oncol. 2009;27:15s, (suppl; abstr 4000).

18.

Roth AD, Tejpar S, Yan P, Fiocca R, Klingbiel D, Delorenzi M, et al. Correlation of molecular markers in colon cancer with stage-specific prognosis: Results of the translational study on the PETACC3 – EORTC 40993-SAKK 60-00 trial. ASCO GI Cancer Symp Abstr. 2009;288.

19.

Ribic CM, Sargent DJ, Moore MJ, et al. Tumor microsatellite-instability status as a predictor of benefit from fluorouracil-based adjuvant chemotherapy for colon cancer. New Engl J Med. 2003;349:247–57.CrossRefPubMed

20.

Sargent DJ, Marsoni S, Thibodeau SN, Labianca R, Hamilton SR, Torri V, et al. Confirmation of deficient mismatch repair (dMMR) as a predictive marker for lack of benefit from 5-FU based chemotherapy in stage II and III colon cancer (CC): a pooled molecular reanalysis of randomized chemotherapy trials. J Clin Oncol. 2008;26: (May 20 suppl; abstr 4008).

Title: Adjuvant Therapy for Colon Cancer: Learning from the Past to Inform the Future
Authors: Daniel Sargent, PhD
Axel Grothey, MD
Publication date: 01-04-2010
Publisher: Springer-Verlag
Published in: Annals of Surgical Oncology / Issue 4/2010
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-009-0880-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Adjuvant Therapy for Colon Cancer: Learning from the Past to Inform the Future

Excerpt

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Excerpt

Please log in to get access to this content

Other articles of this Issue 4/2010

Enhancement the Prediction of Postoperative Survival in Gastric Cancer by Combining the Negative Lymph Node Count with Ratio Between Positive and Examined Lymph Nodes

Gene Expression Profile Prospectively Predicts Peritoneal Relapse After Curative Surgery of Gastric Cancer

Focused Microwave Thermotherapy for Preoperative Treatment of Invasive Breast Cancer: A Review of Clinical Studies

Neoadjuvant Docetaxel, Capecitabine and Cisplatin (DXP) in Patients with Unresectable Locally Advanced or Metastatic Gastric Cancer

Predictors of Survival in Periampullary Cancers Following Pancreaticoduodenectomy

Cost Modeling of Preoperative Axillary Ultrasound and Fine-Needle Aspiration to Guide Surgery for Invasive Breast Cancer