Advances in Adjuvant Therapy for Colon Cancer: P value or Practical Value
Mené en France sur 2 010 patients atteints d'un cancer du côlon de stade III (âge médian : 64 ans), cet essai de phase III compare l'efficacité, du point de vue de la survie sans maladie, et la toxicité d'une chimiothérapie adjuvante de type FOLFOX modifié (fluorouracile, leucovorine, oxaliplatine) et de type CAPOX (capécitabine et oxaliplatine) selon deux durées d'administration du traitement (3 ou 6 mois) (durée médiane de suivi : 4,3 ans)
When infusional fluorouracil, leucovorin, and oxaliplatin (FOLFOX) broke through and became the standard adjuvant therapy for colon cancer in 2004,1 it was expected to be the first of many advances in treating the disease. Three other promising agents were being tested in patients with stage II and III disease; yet, only capecitabine,2 alone or with oxaliplatin (CAPEOX),3 proved effective in that setting. The trials using irinotecan,4,5 bevacizumab6,7 or cetuximab8 all failed with such certainty that the oxaliplatin/fluorouracil combination would remain the backbone of future adjuvant studies. The reports of the Three or Six Colon Adjuvant (TOSCA) trial by Sobrero et al9 and of the International Duration Evaluation of Adjuvant Chemotherapy (IDEA) France by André et al10 that accompany this editorial represent the first findings from the studies that followed.(...)
Journal of Clinical Oncology , éditorial en libre accès, 2017