Gastrointestinal Cancers Symposium
Results from a subgroup analysis of the NO16968 trial showed that
patients of all ages with stage III colon cancer had superior disease-free
survival when assigned to a combination of capecitabine and oxaliplatin (XELOX)
compared with those assigned to standard therapy with 5-FU and leucovorin.
Previous data had shown that older patients either did not benefit or
could not tolerate combination therapy with 5-FU plus leucovorin and
Based on these data, XELOX offers superior DFS benefits with
therapy regardless of age, said Daniel G. Haller, MD, professor of
medicine and Deenie Greitzer Professor of Gastrointestinal Oncology at the
Abramson Cancer Center at the University of Pennsylvania. He presented the
results during a press conference in advance of the 2010 Gastrointestinal
Although the OS benefits are presently immature, there are trends
for OS advantage in all examined groups, and there are many other data yet to
be analyzed that will be presented over the next few years.
Researchers randomly assigned 1,886 patients with stage III colon cancer
to XELOX or 5-FU plus leucovorin. At three years, overall DFS was 71% for those assigned to XELOX vs. 67% for those assigned to
5-FU plus leucovorin.
For patients older than 70, DFS was 66% with XELOX vs. 60% with 5-FU and
leucovorin (HR=0.87; 95% CI, 0.63-1.18). Three-year DFS for patients aged
younger than 70 was 72% for those assigned to XELOX vs. 69% in the 5-FU and
leucovorin group (HR=0.80; 95% CI, 0.65-0.98).
In addition to the two other 5-FU/oxaliplatin regimens, XELOX
offers an additional standard of care for stage III, node-positive colon cancer
regardless of age with superior DFS benefits comparable to the established
combination, and with expectations for survival benefit when patients are
followed beyond six years, Haller said.
He added that XELOX requires fewer office visits than other regimens and
unlike FOLFOX regimens, XELOX does not require a surgically-implanted access
device or infusion pump. by Jason Harris
For more information:
- Haller DG. #284. Presented at: the 2010 Gastrointestinal
Cancers Symposium; Jan. 22-24, 2010; Orlando, Fla.
This is an interesting addition to the prior data on this chemotherapy
regimen, indicating that it is effective in patients older than 70. Certainly,
the numbers were very impressive and I believe this data represents an
important addition to our current knowledge.
Robert P. Sticca, MD
Department of Surgery, University of North Dakota School of Medicine and Health