- By Joe Dangor
Shorter-duration chemotherapy may become standard for treating low-risk stage 3 colon cancer
CHICAGO – For patients with low-risk stage 3 colon cancer, a shorter — three months compared to six months — course of oxaliplatin-based chemotherapy following surgery was associated with fewer and less severe side effects, such as nerve damage. As a result, researchers involved in the International Duration Evaluation of Adjuvant Chemotherapy study, which included six clinical trials of nearly 13,000 patients from 12 countries, say shorter-duration chemotherapy may become the standard of care for patients with low-risk stage 3 colon cancer. Low-risk stage 3 colon cancer was defined as cancer that had not spread to the peritoneal surface or to other organs and did not involve more than three lymph nodes. Results of the study were presented today at the 2017 annual meeting of the American Society of Clinical Oncology in Chicago by Mayo Clinic researchers who are also members of the Alliance for Clinical Trials in Oncology.
"Chemotherapy after surgery, also known as adjuvant therapy, is a standard treatment to increase the cure rate of patients with colon cancer who have undergone surgery and had cancer spread to lymph nodes," says Axel Grothey, M.D., an oncologist at Mayo Clinic and senior author of the study. "The current standard adjuvant therapy, which was established more than a decade ago, is a combination of two or three drugs — one of which is called oxaliplatin — given for about six months."
Dr. Grothey says the key side effect of oxaliplatin is nerve damage that may result in permanent numbness, tingling, and pain in the hands and feet ─ even after the chemotherapy is discontinued. He says the likelihood of developing neurotoxicity and its severity is closely related to the duration of therapy and total dose of oxaliplatin received over time.
"The goal of our study was to investigate if a shorter, three-month duration of oxaliplatin-based therapy is as effective in reducing the risk of cancer recurrence as the standard six- month duration," says co-author Qian Shi, Ph.D., a biostatistician at Mayo Clinic.
Dr. Grothey says a shorter duration of therapy could spare patients potentially unnecessary toxicity and lead to substantial savings in health care expenditure, and become the new standard of care in the postoperative management of patients with low-risk stage 3 colon cancer, which affects approximately 400,000 patients worldwide every year.
Researchers observed a slightly decreased disease-free survival, which is defined as being alive without recurrence of cancer, for patients receiving the shorter duration of therapy for overall stage 3 colon cancer. However, within low-risk stage 3 colon cancer, three months of treatment was shown to be as effective as six months of treatment. Dr. Grothey says study the findings may lead to a more individualized treatment duration based on a patient's individual preference, age, tolerance of therapy and risk of recurrence.
The study was funded by grants from the Medical Research Council, National Institute for Health Research, National Cancer Institute, Italian Agency for Drugs, Japanese Foundation for Multidisciplinary Treatment of Cancer, French Ministry of Health, and French National Cancer Institute. The U.S. study included in the pooled analysis was administered through the Alliance for Clinical Trials in Oncology.
About the Alliance for Clinical Trials in Oncology
The Alliance for Clinical Trials in Oncology comprise nearly 10,000 cancer specialists at hospitals, medical centers and community clinics across the United States and Canada. Through collaboration with the NCI National Clinical Trials Network (NCTN), the Alliance develops and conducts clinical trials with promising new cancer therapies, and utilizes the best science to develop optimal treatment and prevention strategies for cancer, as well as research methods to alleviate side effects of cancer and cancer treatments. To learn more about the Alliance, visit www.allianceforclinicaltrialsinoncology.org.
About Mayo Clinic Cancer Center
As a leading institution funded by the National Cancer Institute, Mayo Clinic Cancer Center conducts basic, clinical and population science research, translating discoveries into improved methods for prevention, diagnosis, prognosis and therapy. For information on cancer clinical trials, call the Clinical Trial Referral Office at 1-855-776-0015 (toll-free).
About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to clinical practice, education and research, providing expert, whole-person care to everyone who needs healing. For more information, visit mayoclinic.org/about-mayo-clinic or newsnetwork.mayoclinic.org.
Joe Dangor, Mayo Clinic Public Affairs, 507-284-5005, email@example.com