Three versus six months adjuvant oxaliplatin-based chemotherapy for patients with stage III colon cancer: The French participation to the International Duration Evaluation of Adjuvant chemotherapy (IDEA) project.

Authors

Thierry Andre

Thierry Andre

Department of Medical Oncology, Hopital Saint-Antoine, APHP, Paris, France

Thierry Andre , Franck Bonnetain , Laurent Mineur , Jaafar Bennouna , Jérôme Desrame , Roger Faroux , Jérôme Dauba , Dewi Vernerey , Nasredine Aissat , Christophe Louvet , Céline Lepère , Olivier Jean Marie Dupuis , Yves Becouarn , May Mabro , Joëlle Egreteau , Olivier Bouche , Gael Deplanque , Marc Ychou , Aimery De Gramont , Julien Taieb

Organizations

Department of Medical Oncology, Hopital Saint-Antoine, APHP, Paris, France, Methodology and Quality of Life Unit, Department of Oncology, INSERM UMR 1098, University Hospital of Besancon; French National Platform Quality of Life and Cancer, Besançon, France, Institut Sainte-Catherine, Avignon, France, Institut de Cancerologie de l'Ouest, Nantes, France, Hopital Prive Jean Mermoz, Lyon, France, Centre Hospitalier Departemental Les Oudairies, La Roche-Sur-Yon, France, Department of Gastroenterology, Hopital Layne, Mont De Marsan, France, Methodological and Quality of Life in Oncology Unit, CHRU Besancon, Besançon, France, GERCOR, Paris, France, Institut Mutualiste Montsouris, Paris, France, Hôpital Européen Georges Pompidou, Paris, France, Clinique Victor Hugo, Le Mans, France, Institut Bergonié, Bordeaux, France, Hôpital Foch, Suresnes, France, Centre Hospitalier Bretagne Sud, Lorient, France, CHU Robert Debre, Reims, France, Medical Oncology, CHUV, Lausanne, Switzerland, Institut Régional du Cancer de Montpellier, Montpellier, France, Franco-British Institute, Levallois-Perret, France, Hopital Européen Georges Pompidou, Paris, France

Research Funding

Other

Background: The IDEA international collaboration was established to combine data from 6 randomized trials to assess whether a 3-month (3M) of oxaliplatin/fluoropyrimidines-based adjuvant chemotherapy (CT) is non-inferior to the 6-month (6M) for 3-year disease free survival (DFS) in stage III colon cancer (CC). Methods: French IDEA randomized patients (pts) between 3M and 6M of CT with mFOLFOX6 or XELOX (physician/pts choice). DFS was estimated using the Kaplan–Meier method and described using 3 years DFS rate. Results: Among 2022 randomized pts between May 2009 and May 2014, 2010 (99.4%) received CT and were enrolled in the mITT population: 49.9 and 50.1% in 3M and 6M, respectively. 99.5% of the mITT pts had stage III (N1: 74.9%; N2: 25.2%); median age 63.9 years; mFOLFOX6: 90% and XELOX 10% of pts. DFS median follow-up is 50.2 months. There were 578 DFS events (314 in 3M and 264 in 6M arm) leading to a 3-year DFS rate of 72.1% in the 3M vs. 75.7% in the 6M (HR=1.24; 95%CI 1.05–1.46, p=0.0112). For pts receiving mFOLFOX6, 3-year DFS rate was 72.0% in the 3M vs. 76.3% in the 6M (HR=1.27; 95%CI 1.07–1.51 p=0.0069). 94.2% and 78.0% of pts completed 3 and 6 months of CT, respectively. Median oxaliplatin doses intensity were 96.9% in 3M and 72.1% in 6M (495.0 and 735.1 mg/m2). By considering the neuropathy grade with 15375 neuropathy longitudinal measurements the overall maximal neuropathy grade 0-1/2/3-4 was 63.6/28.5/7.9% in 3M and 33.4/41.3/25.3% in 6M; p<0.0001. At last follow-up assessment, with a median of 43.1 months, final residual grade 2/3-4 neuropathy was 2.1/0.4% in 3M and 5.4/1.3% in 6M; p<0.0001. Conclusions: The IDEA France study, with 90% of patients treated with mFOLFOX6 regimen has shown that 6 months adjuvant treatment is superior to 3 months treatment. IDEA France study results should be considered in line with the international IDEA project that will also be presented at ASCO 2017. Clinical trial information: 2009-010384-16.

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Abstract Details

Meeting

2017 ASCO Annual Meeting

Session Type

Oral Abstract Session

Session Title

Gastrointestinal (Colorectal) Cancer

Track

Gastrointestinal Cancer—Colorectal and Anal

Sub Track

Colorectal Cancer–Local-Regional Disease

Clinical Trial Registration Number

2009-010384-16

Citation

J Clin Oncol 35, 2017 (suppl; abstr 3500)

DOI

10.1200/JCO.2017.35.15_suppl.3500

Abstract #

3500

Abstract Disclosures