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Lecomte T, Tougeron D, Chautard R, Bressand D, Bibeau F, Blanc B, Cohen R, Jacques J, Lagasse JP, Laurent-Puig P, Lepage C, Lucidarme O, Martin-Babau J, Panis Y, Portales F, Taieb J, Aparicio T, Bouché O. Non-metastatic colon cancer: French Intergroup Clinical Practice Guidelines for diagnosis, treatments, and follow-up (TNCD, SNFGE, FFCD, GERCOR, UNICANCER, SFCD, SFED, SFRO, ACHBT, SFP, AFEF, and SFR). Dig Liver Dis 2024; 56:756-769. [PMID: 38383162 DOI: 10.1016/j.dld.2024.01.208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 01/25/2024] [Accepted: 01/28/2024] [Indexed: 02/23/2024]
Abstract
INTRODUCTION This article is a summary of the French intergroup guidelines regarding the management of non-metastatic colon cancer (CC), revised in November 2022. METHODS These guidelines represent collaborative work of all French medical and surgical societies involved in the management of CC. Recommendations were graded in three categories (A, B, and C) according to the level of evidence found in the literature published up to November 2022. RESULTS Initial evaluation of CC is based on clinical examination, colonoscopy, chest-abdomen-pelvis computed tomography (CT) scan, and carcinoembryonic antigen (CEA) assay. CC is usually managed by surgery and adjuvant treatment depending on the pathological findings. The use of adjuvant therapy remains a challenging question in stage II disease. For high-risk stage II CC, adjuvant chemotherapy must be discussed and fluoropyrimidine monotherapy or oxaliplatin-based chemotherapy proposed according to the type and number of poor prognostic features. Oxaliplatin-based chemotherapy (FOLFOX or CAPOX) is the current standard for adjuvant therapy of patients with stage III CC. However, these regimens are associated with significant oxaliplatin-induced neurotoxicity. The results of the recent IDEA study provide evidence that 3 months of treatment with CAPOX is as effective as 6 months of oxaliplatin-based therapy in patients with low-risk stage III CC (T1-3 and N1). A 6-month oxaliplatin-based therapy remains the standard of care for high-risk stage III CC (T4 and/or N2). For patients unfit for oxaliplatin, fluoropyrimidine monotherapy is recommended. CONCLUSION French guidelines for non-metastatic CC management help to offer the best personalized therapeutic strategy in daily clinical practice. Each individual case must be discussed within a multidisciplinary tumor board and then the treatment option decided with the patient.
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Affiliation(s)
- Thierry Lecomte
- Department of Hepatogastroenterology and Digestive Oncology, Tours University Hospital, Tours, France; Inserm UMR 1069, Nutrition, Croissance et Cancer, Université de Tours, Tours, France.
| | - David Tougeron
- Department of Hepatogastroenterology, Poitiers University Hospital, Poitiers, France
| | - Romain Chautard
- Department of Hepatogastroenterology and Digestive Oncology, Tours University Hospital, Tours, France; Inserm UMR 1069, Nutrition, Croissance et Cancer, Université de Tours, Tours, France
| | - Diane Bressand
- Department of Hepatogastroenterology and Digestive Oncology, Tours University Hospital, Tours, France
| | - Frédéric Bibeau
- Department of Pathology, Besançon University Hospital, Besançon, France
| | - Benjamin Blanc
- Department of Digestive Surgery, Dax Hospital, Dax, France
| | - Romain Cohen
- Sorbonne Université, Department of Medical Oncology, Saint-Antoine hospital, AP-HP, Inserm, Unité Mixte de Recherche Scientifique 938 et SiRIC CURAMUS, Saint-Antoine Research Center, Paris, France
| | - Jérémie Jacques
- Department of Hepatogastroenterology, Limoges University Hospital, Limoges, France
| | - Jean-Paul Lagasse
- Department of Hepatogastroenterology and Digestive Oncology, Orléans University Hospital, Orléans, France
| | - Pierre Laurent-Puig
- Department of Biology, AP-HP, European Georges Pompidou Hospital, Paris, France
| | - Come Lepage
- Department of Hepatogastroenterology and Digestive Oncology, Dijon University Hospital, Dijon, France
| | - Olivier Lucidarme
- Department of Radiology, AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Jérôme Martin-Babau
- Armoricain Center of Radiotherapy, Radiology and Oncology, Côtes D'Armor Private Hospital, Plérin, France
| | - Yves Panis
- Department of Colorectal Surgery, AP-HP, Beaujon Hospital, Clichy, France
| | - Fabienne Portales
- Department of Medical Oncology, Institut du Cancer de Montpellier, Montpellier, France
| | - Julien Taieb
- Department of Gastroenterology and Digestive Oncology, Georges Pompidou European Hospital, Paris, France
| | - Thomas Aparicio
- Department of Gastroenterology and Digestive Oncology, AP-HP, Saint-Louis Hospital, Paris, France
| | - Olivier Bouché
- Department of Digestive Oncology, Reims, CHU Reims, France
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Yao Y, Liu Z, Zhang H, Li J, Peng Z, Yu J, Cao B, Shen L. Serious Adverse Events Reporting in Phase III Randomized Clinical Trials of Colorectal Cancer Treatments: A Systematic Analysis. Front Pharmacol 2021; 12:754858. [PMID: 34867369 PMCID: PMC8636814 DOI: 10.3389/fphar.2021.754858] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 10/25/2021] [Indexed: 12/22/2022] Open
Abstract
Objective: The occurrence, development, and prognosis of serious adverse events (SAEs) associated with anticancer drugs in clinical trials have important guiding significance for real-world clinical applications. However, to date, there have been no studies investigating SAEs reporting in randomized clinical trials of colorectal cancer treatments. This article systematically reviewed the SAEs reporting of phase III randomized clinical trials of colorectal cancer treatments and analyzed the influencing factors. Methods: We reviewed all articles about phase III randomized clinical trials of colorectal cancer treatments published in the PubMed, Embase, Medline, and New England Journal of Medicine databases from January 1, 1993, to December 31, 2018, and searched the registration information of clinical trials via the internet sites such as "clinicaltrials.gov". We analyzed the correlation between the reported proportion (RP) of SAEs in the literature and nine elements, including the clinical trial sponsor and the publication time. Chi-square tests and binary logistic regression were used to identify the factors associated with improved SAEs reports. This study was registered on PROSPERO. Results: Of 1560 articles identified, 160 were eligible, with an RP of SAEs of 25.5% (41/160). In forty-one publications reporting SAEs, only 14.6% (6/41) described the pattern of SAEs in detail. In clinical trials sponsored by pharmaceutical companies, the RP of SAEs was significantly higher than that in those sponsored by investigators (57.6 versus 20.7%, p < 0.001). From 1993 to 2018, the RP of SAEs gradually increased (none (0/6) before 2000, 17.1% (12/70) from 2000 to 2009, and 34.5% (29/84) after 2009). The average RP of SAEs published in the New England Journal of Medicine (N Engl J Med), the Lancet, the Journal of the American Medical Association (JAMA), the Lancet Oncology (Lancet Oncol), and the Journal of Clinical Oncology (J Clin Oncol) was significantly higher than that published in other journals (31.9 versus 16.7%, p = 0.030). In the clinical trials referenced by clinical guidelines, the RP of SAEs was higher than that in non-referenced clinical trials (32.0 versus 15.9%, p = 0.023). Binary logistic regression analysis showed that pharmaceutical company sponsorship, new drug research, and sample size greater than 1000 were positive influencing factors for SAEs reporting. Conclusion: Although the RP of SAEs increased over time, SAEs reporting in clinical trials needs to be further improved. The performance, outcomes and prognosis of SAEs should be reported in detail to guide clinical practice in the real world.
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Affiliation(s)
- Yanhong Yao
- Department of Medical Oncology and Radiation Sickness, Peking University Third Hospital, Beijing, China.,Department of Gastrointestinal Oncology, Peking University Cancer Hospital and Institute, Beijing, China
| | - Zhentao Liu
- Department of Medical Oncology and Radiation Sickness, Peking University Third Hospital, Beijing, China
| | - Hua Zhang
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China
| | - Jian Li
- Department of Gastrointestinal Oncology, Peking University Cancer Hospital and Institute, Beijing, China
| | - Zhi Peng
- Department of Gastrointestinal Oncology, Peking University Cancer Hospital and Institute, Beijing, China
| | - Jinyu Yu
- Department of Medical Oncology and Radiation Sickness, Peking University Third Hospital, Beijing, China
| | - Baoshan Cao
- Department of Medical Oncology and Radiation Sickness, Peking University Third Hospital, Beijing, China
| | - Lin Shen
- Department of Gastrointestinal Oncology, Peking University Cancer Hospital and Institute, Beijing, China
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Maderer A, Fiteni F, Tanis E, Mauer M, Schmitt T, Aust DE, Lutz MP, Roelofson F, Gog C, Weinmann A, Koehne CH, Moehler M, Thomaidis T. CXCR4 and hif-1α as prognostic molecular markers for stage 3 colon cancer patients: post hoc analysis of the randomized, multicenter phase 3 PETACC-2 trial dataset. Acta Oncol 2021; 60:1543-1547. [PMID: 34355650 DOI: 10.1080/0284186x.2021.1959057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- Annett Maderer
- Department of Internal Medicine, Research Center for Immunotherapy (FZI), University Medical Center, Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Frederic Fiteni
- Fellowship Programme Unit, EORTC Headquarters, Brussels, Belgium
| | - Erik Tanis
- Fellowship Programme Unit, EORTC Headquarters, Brussels, Belgium
| | - Murielle Mauer
- Statistics Department, EORTC Headquarters, Brussels, Belgium
| | - Thomas Schmitt
- Department of Internal Medicine, Research Center for Immunotherapy (FZI), University Medical Center, Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Daniela E. Aust
- Molekulare/Prädiktive Diagnostik, Koordination UCC Tumor- und Normalgewebebank Institut für Pathologie, Dresden, Germany
| | | | | | - Christiane Gog
- Klinikum der JW Goethe, Universität Frankfurt am Main, Frankfurt, Germany
| | - Arndt Weinmann
- Department of Internal Medicine, Research Center for Immunotherapy (FZI), University Medical Center, Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Claus H. Koehne
- Department of Oncology and Hematology, Klinikum Oldenburg, European Medical School Oldenburg/Groningen, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
| | - Markus Moehler
- Department of Internal Medicine, Research Center for Immunotherapy (FZI), University Medical Center, Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Thomas Thomaidis
- Department of Internal Medicine, Research Center for Immunotherapy (FZI), University Medical Center, Johannes Gutenberg University of Mainz, Mainz, Germany
- Second Department of Gastroenterology, Hygeia Hospital, Athens, Greece
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Chakrabarti S, Peterson CY, Sriram D, Mahipal A. Early stage colon cancer: Current treatment standards, evolving paradigms, and future directions. World J Gastrointest Oncol 2020; 12:808-832. [PMID: 32879661 PMCID: PMC7443846 DOI: 10.4251/wjgo.v12.i8.808] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 05/16/2020] [Accepted: 08/01/2020] [Indexed: 02/05/2023] Open
Abstract
Colon cancer continues to be one of the leading causes of mortality and morbidity throughout the world despite the availability of reliable screening tools and effective therapies. The majority of patients with colon cancer are diagnosed at an early stage (stages I to III), which provides an opportunity for cure. The current treatment paradigm of early stage colon cancer consists of surgery followed by adjuvant chemotherapy in a select group of patients, which is directed at the eradication of minimal residual disease to achieve a cure. Surgery alone is curative for the vast majority of colon cancer patients. Currently, surgery and adjuvant chemotherapy can achieve long term survival in about two-thirds of colon cancer patients with nodal involvement. Adjuvant chemotherapy is recommended for all patients with stage III colon cancer, while the benefit in stage II patients is not unequivocally established despite several large clinical trials. Contemporary research in early stage colon cancer is focused on minimally invasive surgical techniques, strategies to limit treatment-related toxicities, precise patient selection for adjuvant therapy, utilization of molecular and clinicopathologic information to personalize therapy and exploration of new therapies exploiting the evolving knowledge of tumor biology. In this review, we will discuss the current standard treatment, evolving treatment paradigms, and the emerging biomarkers, that will likely help improve patient selection and personalization of therapy leading to superior outcomes.
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Affiliation(s)
- Sakti Chakrabarti
- Division of Hematology/Oncology, Medical College of Wisconsin, Milwaukee, WI 53226, United States
| | - Carrie Y Peterson
- Department of Surgery, Medical College of Wisconsin, Milwaukee, WI 53226, United States
| | - Deepika Sriram
- Division of Hematology/Oncology, Medical College of Wisconsin, Milwaukee, WI 53226, United States
| | - Amit Mahipal
- Division of Medical Oncology, Mayo Clinic, Rochester, MN 55905, United States
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Cohen R, Vernerey D, Bellera C, Meurisse A, Henriques J, Paoletti X, Rousseau B, Alberts S, Aparicio T, Boukovinas I, Gill S, Goldberg RM, Grothey A, Hamaguchi T, Iveson T, Kerr R, Labianca R, Lonardi S, Meyerhardt J, Paul J, Punt CJA, Saltz L, Saunders MP, Schmoll HJ, Shah M, Sobrero A, Souglakos I, Taieb J, Takashima A, Wagner AD, Ychou M, Bonnetain F, Gourgou S, Yoshino T, Yothers G, de Gramont A, Shi Q, André T. Guidelines for time-to-event end-point definitions in adjuvant randomised trials for patients with localised colon cancer: Results of the DATECAN initiative. Eur J Cancer 2020; 130:63-71. [PMID: 32172199 PMCID: PMC7409551 DOI: 10.1016/j.ejca.2020.02.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 02/05/2020] [Accepted: 02/08/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND The variability of definitions for time-to-event (TTE) end-points impacts the conclusions of randomised clinical trials (RCTs). The Definition for the Assessment of Time-to-event Endpoints in CANcer (DATECAN) initiative aims to provide consensus definitions for TTE end-points used in RCTs. Here, we formulate guidelines for adjuvant colon cancer RCTs. METHODS We performed a literature review to identify TTE end-points and events included in their definition in RCT publications. Then, a consensus was reached among a panel of international experts, using a formal modified Delphi method, with 2 rounds of questionnaires and an in-person meeting. RESULTS Twenty-four experts scored 72 events involved in 6 TTE end-points. Consensus was reached for 24%, 57% and 100% events after the first round, second round and in-person meeting. For RCTs not using overall survival as their primary end-point, the experts recommend using disease-free survival (DFS) rather than recurrence-free survival (RFS) or time to recurrence (TTR) as the primary end-point. The consensus definition of DFS includes all causes of death, second primary colorectal cancers (CRCs), anastomotic relapse and metastatic relapse as an event, but not second primary non-CRCs. Events included in the RFS definition are the same as for DFS with the exception of second primary CRCs. The consensus definition of TTR includes anastomotic or metastatic relapse, death with evidence of recurrence and death from CC cause. CONCLUSION Standardised definitions of TTE end-points ensure the reproducibility of the end-points between RCTs and facilitate cross-trial comparisons. These definitions should be integrated in standard practice for the design, reporting and interpretation of adjuvant CC RCTs.
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Affiliation(s)
- Romain Cohen
- Sorbonne Université, Department of Medical Oncology, AP-HP, Hôpital Saint-Antoine, F-7512, Paris, France; Division of Biomedical Statistics and Informatics, Department of Health Science Research, Mayo Clinic, Rochester, MN, USA.
| | - Dewi Vernerey
- Methodology and Quality of Life Unit in Oncology, University Hospital of Besançon, F-25000, Besançon, France; University Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, F-25000, Besançon, France
| | - Carine Bellera
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, Epicene Team, UMR 1219, F-33000 Bordeaux, France; Inserm CIC1401, Clinical and Epidemiological Research Unit, Institut Bergonié, Comprehensive Cancer Center, F-33000, Bordeaux, France
| | - Aurélia Meurisse
- Methodology and Quality of Life Unit in Oncology, University Hospital of Besançon, F-25000, Besançon, France; University Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, F-25000, Besançon, France
| | - Julie Henriques
- Methodology and Quality of Life Unit in Oncology, University Hospital of Besançon, F-25000, Besançon, France; University Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, F-25000, Besançon, France
| | - Xavier Paoletti
- Université de Versailles-St Quentin & Institut Curie, INSERM U900, équipe Biostatistique, France
| | | | | | - Thomas Aparicio
- Service de Gastroentérologie et Cancérologie Digestive, Hôpital Saint Louis, APHP, Université de Paris, Paris, France
| | | | | | | | - Axel Grothey
- West Cancer Center and Research Institute, Germantown, TN, USA
| | - Tetsuya Hamaguchi
- Department of Gastroenterological Oncology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Timothy Iveson
- University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Rachel Kerr
- Adjuvant Colorectal Cancer Group, University of Oxford, UK
| | | | | | - Jeffrey Meyerhardt
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA
| | - James Paul
- Cancer Research UK Clinical Trials Unit (CTU), Institute of Cancer Sciences, University of Glasgow, UK
| | - Cornelis J A Punt
- Department of Medical Oncology, Amsterdam University Medical Centers, University of Amsterdam, Netherlands
| | - Leonard Saltz
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Marck P Saunders
- Department of Clinical Oncology, The Christie NHS Foundation Trust, Manchester, UK
| | - Hans-Joachim Schmoll
- EORTC GI Study Group, AIO Colorectal Cancer Group, Martin Luther University, Halle, Germany
| | - Manish Shah
- Department of Medicine, Division of Hematology and Medical Oncology, Center for Advanced Digestive Care, Weill Cornell Medicine, New York-Presbyterian Hospital, New York, NY, USA
| | - Alberto Sobrero
- Medical Oncology Unit at Ospedale San Martino, Genova, Italy
| | | | - Julien Taieb
- Sorbonne Paris Cité, Paris Descartes University, Department of Digestive Oncology, Georges Pompidou European Hospital, Paris, France
| | | | - Anna Dorothea Wagner
- Department of Oncology, Lausanne University Hospital and University of Lausanne, Switzerland
| | - Marc Ychou
- Department of Medical Oncology, Institut Régional Du Cancer de Montpellier (ICM), France
| | - Franck Bonnetain
- Methodology and Quality of Life Unit in Oncology, University Hospital of Besançon, F-25000, Besançon, France; University Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, F-25000, Besançon, France
| | - Sophie Gourgou
- Biometrics Unit, Montpellier Cancer Institute, Univ Montpellier, Montpellier, France
| | | | | | - Aimery de Gramont
- Department of Medical Oncology, Institut Hospitalier Franco Britannique, Levallois-Perret, France
| | - Qian Shi
- Division of Biomedical Statistics and Informatics, Department of Health Science Research, Mayo Clinic, Rochester, MN, USA
| | - Thierry André
- Sorbonne Université, Department of Medical Oncology, AP-HP, Hôpital Saint-Antoine, F-7512, Paris, France
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Lombardi P, Marandino L, De Luca E, Zichi C, Reale ML, Pignataro D, Di Stefano RF, Ghisoni E, Mariniello A, Trevisi E, Leone G, Muratori L, La Salvia A, Sonetto C, Leone F, Aglietta M, Novello S, Scagliotti GV, Perrone F, Di Maio M. Quality of life assessment and reporting in colorectal cancer: A systematic review of phase III trials published between 2012 and 2018. Crit Rev Oncol Hematol 2020; 146:102877. [PMID: 31981880 DOI: 10.1016/j.critrevonc.2020.102877] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Revised: 12/09/2019] [Accepted: 01/17/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND In this study, our aim was to describe quality of life (QoL) prevalence and heterogeneity in QoL reporting in colorectal cancer phase III trials. METHODS We included all phase III trials evaluating anticancer drugs in colorectal cancer patients published between 2012 and 2018 by 11 major journals. RESULTS Out of the 67 publications identified, in 41 (61.2 %) QoL was not listed among endpoints. Out of 26 primary publications of trials including QoL among endpoints, QoL results were not reported in 10 (38.5 %). Overall, no QoL data were available in 51/67 (76.1 %) primary publications. In particular, in the metastatic setting, QoL data were not available in 12/18 (66.7 %) trials with primary endpoint overall survival, and in 20/29 (69.0 %) trials with other primary endpoints. CONCLUSIONS QoL was absent in a high proportion of recently published phase III trials in colorectal cancer, even in trials of second or further lines, where attention to QoL should be particularly high.
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Affiliation(s)
- Pasquale Lombardi
- Department of Oncology, University of Turin, Candiolo Cancer Institute - FPO- IRCCS, Candiolo, TO, Italy
| | - Laura Marandino
- Department of Oncology, University of Turin, Candiolo Cancer Institute - FPO- IRCCS, Candiolo, TO, Italy
| | - Emmanuele De Luca
- Department of Oncology, University of Turin, Ordine Mauriziano Hospital, Torino, Italy
| | - Clizia Zichi
- Department of Oncology, University of Turin, Ordine Mauriziano Hospital, Torino, Italy
| | - Maria Lucia Reale
- Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, TO, Italy
| | - Daniele Pignataro
- Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, TO, Italy
| | - Rosario F Di Stefano
- Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, TO, Italy
| | - Eleonora Ghisoni
- Department of Oncology, University of Turin, Candiolo Cancer Institute - FPO- IRCCS, Candiolo, TO, Italy
| | - Annapaola Mariniello
- Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, TO, Italy
| | - Elena Trevisi
- Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, TO, Italy
| | - Gianmarco Leone
- Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, TO, Italy
| | - Leonardo Muratori
- Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, TO, Italy
| | - Anna La Salvia
- Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, TO, Italy
| | - Cristina Sonetto
- Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, TO, Italy
| | - Francesco Leone
- Department of Oncology, University of Turin, Candiolo Cancer Institute - FPO- IRCCS, Candiolo, TO, Italy
| | - Massimo Aglietta
- Department of Oncology, University of Turin, Candiolo Cancer Institute - FPO- IRCCS, Candiolo, TO, Italy
| | - Silvia Novello
- Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, TO, Italy
| | - Giorgio V Scagliotti
- Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, TO, Italy
| | - Francesco Perrone
- Clinical Trials Unit, Istituto Nazionale per lo Studio e la Cura dei Tumori "Fondazione Giovanni Pascale"-IRCCS, Napoli, Italy
| | - Massimo Di Maio
- Department of Oncology, University of Turin, Ordine Mauriziano Hospital, Torino, Italy.
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You X, Kang Y, Hollett G, Chen X, Zhao W, Gu Z, Wu J. Polymeric nanoparticles for colon cancer therapy: overview and perspectives. J Mater Chem B 2016; 4:7779-7792. [DOI: 10.1039/c6tb01925k] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Colorectal cancer (CRC) is the third-most common malignant tumour and is associated with high morbidity and mortality worldwide.
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Affiliation(s)
- Xinru You
- School of Engineering
- Sun Yat-sen University
- Guangzhou
- P. R. China
| | - Yang Kang
- Key Laboratory of Mountain Ecological Restoration and Bioresource Utilization
- Chengdu Institute of Biology
- Chinese Academy of Sciences
- Chengdu 610041
- China
| | - Geoffrey Hollett
- Materials Science and Engineering Program
- University of California San Diego
- La Jolla
- USA
| | - Xing Chen
- School of Engineering
- Sun Yat-sen University
- Guangzhou
- P. R. China
| | - Wei Zhao
- Key Laboratory for Stem Cells and Tissue Engineering
- Ministry of Education
- Sun Yat-sen University
- Guangzhou
- China
| | - Zhipeng Gu
- School of Engineering
- Sun Yat-sen University
- Guangzhou
- P. R. China
| | - Jun Wu
- School of Engineering
- Sun Yat-sen University
- Guangzhou
- P. R. China
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Schmoll HJ, Tabernero J, Maroun J, de Braud F, Price T, Van Cutsem E, Hill M, Hoersch S, Rittweger K, Haller DG. Capecitabine Plus Oxaliplatin Compared With Fluorouracil/Folinic Acid As Adjuvant Therapy for Stage III Colon Cancer: Final Results of the NO16968 Randomized Controlled Phase III Trial. J Clin Oncol 2015; 33:3733-40. [PMID: 26324362 DOI: 10.1200/jco.2015.60.9107] [Citation(s) in RCA: 185] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
PURPOSE To report the final efficacy findings and biomarker analysis from the NO16968 trial comparing bolus fluorouracil/folinic acid (FU/FA) with capecitabine plus oxaliplatin (XELOX) in resected stage III colon cancer. PATIENTS AND METHODS After curative resection, patients were randomly assigned to receive XELOX, as oxaliplatin 130 mg/m(2) on day 1 and capecitabine 1,000 mg/m(2) twice daily on days 1 to 14 every 3 weeks, or bolus FU/FA, as the Mayo Clinic or Roswell Park regimens, for 6 months. The primary end point was disease-free survival (DFS). Secondary end points included overall survival (OS). RESULTS The intention-to-treat population comprised 1,886 patients (XELOX, n = 944; FU/FA, n = 942). Seven-year DFS rates were 63% and 56% in the XELOX and FU/FA groups, respectively (hazard ratio [HR], 0.80; 95% CI, 0.69 to 0.93; P = .004). Seven-year OS rates were 73% and 67% in the XELOX and FU/FA groups, respectively (HR, 0.83; 95% CI, 0.70 to 0.99; P = .04). A total of 68% and 77% of patients who experienced relapse or a new colorectal cancer in the XELOX and FU/FA groups, respectively, received drug treatment for metastatic disease. Four hundred ninety-eight patients consented to the biomarker analysis: 242 in the XELOX group and 256 in the FU/FA group. Low tumor expression of dihydropyrimidine dehydrogenase may be predictive for XELOX efficacy; in the XELOX group, for high versus low dihydropyrimidine dehydrogenase expression levels, DFS HR was 2.45 (95% CI, 1.55 to 3.86; P < .001), and OS HR was 2.75 (95% CI, 1.65 to 4.59; P < .001). In the FU/FA group, no statistically significant associations were observed between any tumor biomarker and outcomes. CONCLUSION XELOX improved OS compared with bolus FU/FA in patients with resected stage III colon cancer after a median follow-up of almost 7 years. XELOX should be considered a standard adjuvant treatment option in patients with stage III disease. Tumoral dihydropyrimidine dehydrogenase expression is a promising predictive, and potentially, highly clinically relevant, biomarker for XELOX efficacy requiring further prospective evaluation.
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Affiliation(s)
- Hans-Joachim Schmoll
- Hans-Joachim Schmoll, Martin Luther University, Halle, Germany; Josep Tabernero, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain; Jean Maroun, Ottawa Regional Cancer Center, Ottawa, Ontario, Canada; Filippo de Braud, Istituto Europeo di Oncologia, Milan, Italy; Timothy Price, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia; Eric Van Cutsem, University Hospital Gasthuisberg, Leuven, Belgium; Mark Hill, Kent Oncology Centre, Maidstone, Kent, United Kingdom; Silke Hoersch, F. Hoffmann-La Roche, Basel, Switzerland; Karen Rittweger, F. Hoffmann-La Roche, Nutley, NJ; and Daniel G. Haller, University of Pennsylvania, Philadelphia, PA.
| | - Josep Tabernero
- Hans-Joachim Schmoll, Martin Luther University, Halle, Germany; Josep Tabernero, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain; Jean Maroun, Ottawa Regional Cancer Center, Ottawa, Ontario, Canada; Filippo de Braud, Istituto Europeo di Oncologia, Milan, Italy; Timothy Price, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia; Eric Van Cutsem, University Hospital Gasthuisberg, Leuven, Belgium; Mark Hill, Kent Oncology Centre, Maidstone, Kent, United Kingdom; Silke Hoersch, F. Hoffmann-La Roche, Basel, Switzerland; Karen Rittweger, F. Hoffmann-La Roche, Nutley, NJ; and Daniel G. Haller, University of Pennsylvania, Philadelphia, PA
| | - Jean Maroun
- Hans-Joachim Schmoll, Martin Luther University, Halle, Germany; Josep Tabernero, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain; Jean Maroun, Ottawa Regional Cancer Center, Ottawa, Ontario, Canada; Filippo de Braud, Istituto Europeo di Oncologia, Milan, Italy; Timothy Price, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia; Eric Van Cutsem, University Hospital Gasthuisberg, Leuven, Belgium; Mark Hill, Kent Oncology Centre, Maidstone, Kent, United Kingdom; Silke Hoersch, F. Hoffmann-La Roche, Basel, Switzerland; Karen Rittweger, F. Hoffmann-La Roche, Nutley, NJ; and Daniel G. Haller, University of Pennsylvania, Philadelphia, PA
| | - Filippo de Braud
- Hans-Joachim Schmoll, Martin Luther University, Halle, Germany; Josep Tabernero, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain; Jean Maroun, Ottawa Regional Cancer Center, Ottawa, Ontario, Canada; Filippo de Braud, Istituto Europeo di Oncologia, Milan, Italy; Timothy Price, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia; Eric Van Cutsem, University Hospital Gasthuisberg, Leuven, Belgium; Mark Hill, Kent Oncology Centre, Maidstone, Kent, United Kingdom; Silke Hoersch, F. Hoffmann-La Roche, Basel, Switzerland; Karen Rittweger, F. Hoffmann-La Roche, Nutley, NJ; and Daniel G. Haller, University of Pennsylvania, Philadelphia, PA
| | - Timothy Price
- Hans-Joachim Schmoll, Martin Luther University, Halle, Germany; Josep Tabernero, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain; Jean Maroun, Ottawa Regional Cancer Center, Ottawa, Ontario, Canada; Filippo de Braud, Istituto Europeo di Oncologia, Milan, Italy; Timothy Price, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia; Eric Van Cutsem, University Hospital Gasthuisberg, Leuven, Belgium; Mark Hill, Kent Oncology Centre, Maidstone, Kent, United Kingdom; Silke Hoersch, F. Hoffmann-La Roche, Basel, Switzerland; Karen Rittweger, F. Hoffmann-La Roche, Nutley, NJ; and Daniel G. Haller, University of Pennsylvania, Philadelphia, PA
| | - Eric Van Cutsem
- Hans-Joachim Schmoll, Martin Luther University, Halle, Germany; Josep Tabernero, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain; Jean Maroun, Ottawa Regional Cancer Center, Ottawa, Ontario, Canada; Filippo de Braud, Istituto Europeo di Oncologia, Milan, Italy; Timothy Price, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia; Eric Van Cutsem, University Hospital Gasthuisberg, Leuven, Belgium; Mark Hill, Kent Oncology Centre, Maidstone, Kent, United Kingdom; Silke Hoersch, F. Hoffmann-La Roche, Basel, Switzerland; Karen Rittweger, F. Hoffmann-La Roche, Nutley, NJ; and Daniel G. Haller, University of Pennsylvania, Philadelphia, PA
| | - Mark Hill
- Hans-Joachim Schmoll, Martin Luther University, Halle, Germany; Josep Tabernero, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain; Jean Maroun, Ottawa Regional Cancer Center, Ottawa, Ontario, Canada; Filippo de Braud, Istituto Europeo di Oncologia, Milan, Italy; Timothy Price, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia; Eric Van Cutsem, University Hospital Gasthuisberg, Leuven, Belgium; Mark Hill, Kent Oncology Centre, Maidstone, Kent, United Kingdom; Silke Hoersch, F. Hoffmann-La Roche, Basel, Switzerland; Karen Rittweger, F. Hoffmann-La Roche, Nutley, NJ; and Daniel G. Haller, University of Pennsylvania, Philadelphia, PA
| | - Silke Hoersch
- Hans-Joachim Schmoll, Martin Luther University, Halle, Germany; Josep Tabernero, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain; Jean Maroun, Ottawa Regional Cancer Center, Ottawa, Ontario, Canada; Filippo de Braud, Istituto Europeo di Oncologia, Milan, Italy; Timothy Price, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia; Eric Van Cutsem, University Hospital Gasthuisberg, Leuven, Belgium; Mark Hill, Kent Oncology Centre, Maidstone, Kent, United Kingdom; Silke Hoersch, F. Hoffmann-La Roche, Basel, Switzerland; Karen Rittweger, F. Hoffmann-La Roche, Nutley, NJ; and Daniel G. Haller, University of Pennsylvania, Philadelphia, PA
| | - Karen Rittweger
- Hans-Joachim Schmoll, Martin Luther University, Halle, Germany; Josep Tabernero, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain; Jean Maroun, Ottawa Regional Cancer Center, Ottawa, Ontario, Canada; Filippo de Braud, Istituto Europeo di Oncologia, Milan, Italy; Timothy Price, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia; Eric Van Cutsem, University Hospital Gasthuisberg, Leuven, Belgium; Mark Hill, Kent Oncology Centre, Maidstone, Kent, United Kingdom; Silke Hoersch, F. Hoffmann-La Roche, Basel, Switzerland; Karen Rittweger, F. Hoffmann-La Roche, Nutley, NJ; and Daniel G. Haller, University of Pennsylvania, Philadelphia, PA
| | - Daniel G Haller
- Hans-Joachim Schmoll, Martin Luther University, Halle, Germany; Josep Tabernero, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain; Jean Maroun, Ottawa Regional Cancer Center, Ottawa, Ontario, Canada; Filippo de Braud, Istituto Europeo di Oncologia, Milan, Italy; Timothy Price, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia; Eric Van Cutsem, University Hospital Gasthuisberg, Leuven, Belgium; Mark Hill, Kent Oncology Centre, Maidstone, Kent, United Kingdom; Silke Hoersch, F. Hoffmann-La Roche, Basel, Switzerland; Karen Rittweger, F. Hoffmann-La Roche, Nutley, NJ; and Daniel G. Haller, University of Pennsylvania, Philadelphia, PA
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9
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Glimelius B. Is the benefit of oxaliplatin in rectal cancer clinically relevant? Lancet Oncol 2015; 16:883-5. [PMID: 26189066 DOI: 10.1016/s1470-2045(15)00018-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Accepted: 05/27/2015] [Indexed: 10/23/2022]
Affiliation(s)
- Bengt Glimelius
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden.
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10
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Peixoto RD, Kumar A, Speers C, Renouf D, Kennecke HF, Lim HJ, Cheung WY, Melosky B, Gill S. Effect of delay in adjuvant oxaliplatin-based chemotherapy for stage III colon cancer. Clin Colorectal Cancer 2014; 14:25-30. [PMID: 25465343 DOI: 10.1016/j.clcc.2014.10.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2014] [Revised: 10/16/2014] [Accepted: 10/27/2014] [Indexed: 12/24/2022]
Abstract
BACKGROUND Less than 8 weeks has been recommended as the optimal time to initiate AC based on 2 meta-analyses that suggested worse survival with delayed AC. However, neither study included patients treated with an oxaliplatin-based chemotherapy. We aimed to investigate the effect of delay in initiating oxaliplatin-based chemotherapy on RFS and CSS for stage III colon cancer. PATIENTS AND METHODS Records of patients who initiated oxaliplatin-based AC for stage III colon cancer between 2006 and 2011 at the British Columbia Cancer Agency were retrospectively reviewed. Cox proportional models were used to analyze the effect of time to AC (TTAC) on RFS and CSS. TTAC was categorized into ≤ 8 weeks (G1) and > 8 weeks (G2). RESULTS Six hundred thirty-five patients were included (G1, n = 291; G2, n = 344). Median time from surgery to initiation of AC was 8.3 weeks. At a median follow-up of 57.9 months, 176 patients (27.7%) had disease recurrence and 118 (18.6%) had died. Five-year RFS was 70.9% (95% confidence interval [CI], 65.2-76.5) for G1 and 72.1% (95% CI, 67.2-77) for G2. Five-year CSS was 82% for G1 (95% CI, 87.09-76.91) and 82.8% for G2 (95% CI, 78.30-87.30). On multivariate analysis, delayed TTAC did not have prognostic significance on either RFS (hazard ratio [HR], 1.08; P = .609) or CSS (HR, 1.02; P = .893). CONCLUSION In our population-based study, TTAC after stage III colon cancer resection did not have an effect on RFS or CSS. Contrary to most of the existing data, which are primarily based on 5-fluorouracil-based AC, delay of oxaliplatin-based AC beyond 8 weeks did not appear to be associated with inferior outcomes.
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Affiliation(s)
- Renata D'Alpino Peixoto
- Division of Medical Oncology, University of British Columbia, British Columbia Cancer Agency, Vancouver, British Columbia, Canada.
| | - Aalok Kumar
- Division of Medical Oncology, University of British Columbia, British Columbia Cancer Agency, Vancouver, British Columbia, Canada
| | - Caroline Speers
- Division of Medical Oncology, University of British Columbia, British Columbia Cancer Agency, Vancouver, British Columbia, Canada
| | - Daniel Renouf
- Division of Medical Oncology, University of British Columbia, British Columbia Cancer Agency, Vancouver, British Columbia, Canada
| | - Hagen F Kennecke
- Division of Medical Oncology, University of British Columbia, British Columbia Cancer Agency, Vancouver, British Columbia, Canada
| | - Howard J Lim
- Division of Medical Oncology, University of British Columbia, British Columbia Cancer Agency, Vancouver, British Columbia, Canada
| | - Winson Y Cheung
- Division of Medical Oncology, University of British Columbia, British Columbia Cancer Agency, Vancouver, British Columbia, Canada
| | - Barbara Melosky
- Division of Medical Oncology, University of British Columbia, British Columbia Cancer Agency, Vancouver, British Columbia, Canada
| | - Sharlene Gill
- Division of Medical Oncology, University of British Columbia, British Columbia Cancer Agency, Vancouver, British Columbia, Canada
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11
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Rateesh S, Luis SA, Luis CR, Hughes B, Nicolae M. Myocardial infarction secondary to 5-fluorouracil: not an absolute contraindication to rechallenge? Int J Cardiol 2014; 172:e331-3. [PMID: 24447743 DOI: 10.1016/j.ijcard.2013.12.274] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2013] [Accepted: 12/29/2013] [Indexed: 10/25/2022]
Affiliation(s)
- Shruti Rateesh
- Department of Cardiology, The Prince Charles Hospital, Chermside, Queensland, Australia
| | - Sushil A Luis
- Department of Cardiology, The Prince Charles Hospital, Chermside, Queensland, Australia; Division of Cardiovascular Diseases, Department of Medicine, Mayo Clinic, Rochester, MN, United States; School of Medicine, University of Queensland, Herston, Queensland, Australia.
| | - Chris R Luis
- Department of Cardiology, The Prince Charles Hospital, Chermside, Queensland, Australia
| | - Brett Hughes
- Department of Oncology, The Prince Charles Hospital, Chermside, Queensland, Australia
| | - Mugur Nicolae
- Department of Cardiology, The Prince Charles Hospital, Chermside, Queensland, Australia
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