Treatment
Summary of Key Evidence from the International Duration Evaluation
of Adjuvant Chemotherapy (IDEA) Collaboration (n = 12,834):
➤ Using a predefined threshold, noninferiority of three months compared
to six months of oxaliplatin-containing chemotherapy was not proven for
disease-free survival (DFS), the primary outcome.
➤ The relative risk of all grade 3-4 adverse events, and grade 3-4 peripheral
sensory neurotoxicity up to one month post-treatment was significantly
lower with three months vs. six months of dual agent chemotherapy.
Exploratory subgroup analyses by risk of recurrence:
➤ Within the high-risk group defined in the IDEA Collaboration (T4 and/or
N2), superior DFS was found with 6 months versus 3 months duration of
dual-agent chemotherapy.
➤ Within the low-risk group (T1 to 3, N1), DFS was noninferior with 3 months
versus 6 months duration of dual-agent chemotherapy.
Prespecified subgroup analysis by type of oxaliplatin-based
chemotherapy:
➤ 3 months of treatment was not inferior to 6 months for patients treated
CAPOX.
➤ 3 months of treatment was found to be inferior to 6 months for patients
treated with FOLFOX.
Reference: Grothey A, Sobrero AF, Shields AF, et al: Duration of adjuvant chemotherapy for
stage III colon cancer. N Engl J Med 378:1177-1188, 2018.
