Study Finds Adding Adjuvant Oxaliplatin to Fluoropyrimidine of Benefit in Deficient Mismatch Repair Colon Cancer

Key Points

  • Adding adjuvant oxaliplatin to fluoropyrimidine treatment improved disease-free survival in patients with deficient mismatch repair colon cancer.
  • The benefit appeared to be limited to patients with stage III disease.

In a French retrospective study reported in the Journal of the National Cancer Institute, Tougeron et al found that the addition of adjuvant oxaliplatin to fluoropyrimidine treatment improved disease-free survival in patients with stage III deficient mismatch repair colon cancer.

Study Details

The study included 433 consecutive patients undergoing curative surgical resection for stage II or III deficient mismatch repair colon cancer between 2000 and 2011 at 11 French centers. Of them, 56.8% had stage II, and 43.2% had stage III disease. Patients received surgery alone (n = 263) or surgery with chemotherapy consisting of fluoropyrimidine with (n = 119) or without (n = 51) oxaliplatin. Adjuvant chemotherapy was given to 6.7% of patients with stage II disease (mainly those with high-risk disease) and 69.0% of patients with stage III disease.

Improved Disease-Free Survival

Mean follow-up was 47.0 months. On multivariate analysis, compared with surgery alone, oxaliplatin-based chemotherapy was associated with significantly improved disease-free survival (hazard ratio [HR] = 0.35, P < .001), whereas improvement with fluoropyrimidine treatment alone was not significant (HR = 0.73, P = .38).

In a subgroup analysis, the disease-free survival benefit of oxaliplatin-based chemotherapy was significant only among patients with stage III disease (HR = 0.41, P = .02). Among high-risk stage II patients, hazard ratios were 0.13 (P = .06) with oxaliplatin-based treatment and 0.85 (P = .83) with fluoropyrimidine treatment alone.

The investigators concluded: “This study supports the use of adjuvant chemotherapy with fluoropyrimidine plus oxaliplatin in stage III deficient mismatch repair [colon cancer].”

David Tougeron, MD, PhD, of Poitiers University Hospital, Poitiers, France, is the corresponding author of the Journal of the National Cancer Institute article.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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