Capecitabine plus oxaliplatin (XELOX) versus bolus 5-fluorouracil/leucovorin (5-FU/LV) as adjuvant therapy for stage III colon cancer: Survival follow-up of study NO16968 (XELOXA).

Authors

null

Hans-Joachim Schmoll

University Clinic Halle (Saale), Halle, Germany

Hans-Joachim Schmoll , Josep Tabernero , Jean Alfred Maroun , Filippo G. De Braud , Timothy Jay Price , Eric Van Cutsem , Mark Hill , Silke Hoersch , Karen Rittweger , Daniel G. Haller

Organizations

University Clinic Halle (Saale), Halle, Germany, Vall d'Hebron University Hospital, Barcelona, Spain, Ottawa Regional Cancer Centre, Ottawa, ON, Canada, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy, The Queen Elizabeth Hospital, Adelaide, Australia, University Hospital Gasthuisberg/Leuven, Leuven, Belgium, Kent Oncology Centre, Maidstone, United Kingdom, Dr. Manfred Köhler GmbH/Roche, Freiburg, Germany, Hoffmann-La Roche Inc., Nutley, NJ, University of Pennsylvania, Philadelphia, PA

Research Funding

Pharmaceutical/Biotech Company

Background: The MOSAIC trial demonstrated that adding oxaliplatin to 5-FU/LV (FOLFOX4) improved 3-year disease-free survival (DFS) compared to infusional and bolus 5-FU/LV as adjuvant therapy in patients (pts) with stage II/III colon cancer [André et al. NEJM 2004]. A significant survival advantage for FOLFOX4 versus 5-FU/LV was not evident until after median duration of follow-up had exceeded 6 years [André et al. JCO 2009]. Study NO16968 demonstrated that XELOX was superior to bolus 5-FU/LV as adjuvant therapy in pts with stage III colon cancer in terms of DFS at 57 months median follow-up (HR 0.80; 95% CI 0.69–0.93; p=0.0045) [Haller et al. JCO 2011]. The difference between treatment groups in overall survival (OS) was not significant at 59 months median follow-up (HR=0.87; p=0.1486). Data from the planned final analysis of NO16968 are presented. Methods: Pts with resected stage III colon cancer were randomized to receive XELOX (8 cycles, 24w) or bolus 5-FU/LV (Mayo Clinic, 6 cycles; 24w or Roswell Park, 4 cycles; 32w). The primary study endpoint was DFS. Secondary endpoints included OS. Results: The ITT population included 1886 pts (XELOX, n=944; 5-FU/LV, n=942). After a median follow-up of 74 months, the HR (XELOX vs 5-FU/LV) for DFS was 0.80 (95% CI 0.69–0.93; p=0.0038). Seven-year DFS rates were 63% for XELOX and 56% for 5-FU/LV. After a median follow-up of 83 months, the HR for OS was 0.83 (95% CI 0.70–0.99; p=0.0367). Absolute 7-year OS rates were 73% with XELOX and 67% with 5-FU/LV. After adjusting for stratification and prognostic variables, HRs remained essentially unchanged for both DFS (0.79; 95% CI 0.68–0.91; p=0.0016) and OS (0.84; 95% CI 0.71–1.00; p=0.0477). Locoregional / systemic treatments after recurrence were given in 230 (24%) XELOX pts and 308 (33%) 5-FU/LV pts. Conclusions: The combination of oxaliplatin and capecitabine improves OS significantly compared with 5-FU/LV in the adjuvant treatment of stage III colon cancer after a median follow-up of 83 months; these data are comparable to those achieved with FOLFOX4 in the MOSAIC trial. XELOX is an effective adjuvant therapy option for pts with resected stage III colon cancer.

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Abstract Details

Meeting

2012 Gastrointestinal Cancers Symposium

Session Type

Poster Session

Session Title

General Poster Session C: Cancers of the Colon and Rectum

Track

Cancers of the Colon, Rectum, and Anus

Sub Track

Multidisciplinary Treatment

Clinical Trial Registration Number

NCT00069121

Citation

J Clin Oncol 30, 2012 (suppl 4; abstr 388)

DOI

10.1200/jco.2012.30.4_suppl.388

Abstract #

388

Poster Bd #

A7

Abstract Disclosures