Reintroduction of oxaliplatin is associated with improved survival in advanced colorectal cancer.
Authors: de Gramont, A. et al.
Journal: J Clin Oncol
Volume: 25
Issue: 22
Pages: 3224-3229
eISSN: 1527-7755
DOI: 10.1200/JCO.2006.10.4380
Abstract:PURPOSE: In the OPTIMOX1 trial, previously untreated patients with advanced colorectal cancer were randomly assigned to two different schedules of leucovorin, fluorouracil, and oxaliplatin that were administered until progression in the control arm or in a stop-and-go fashion in the experimental arm. The randomly assigned treatment groups did not differ significantly in terms of response rate, progression-free survival, and overall survival (OS). However, the impact of oxaliplatin reintroduction on OS was potentially masked by the fact that a large number of patients did not receive the planned oxaliplatin reintroduction or received oxaliplatin after second-line therapy in both treatment groups. PATIENTS AND METHODS: A Cox model was fitted with all significant baseline factors plus time-dependent variables reflecting tumor progression, reintroduction of oxaliplatin, and use of second-line irinotecan. A shared frailty model was fitted with all significant baseline factors plus the number of lines of chemotherapy received by the patient and the percentage of patients with oxaliplatin reintroduction in the center. An adjusted hazard ratio (HR) was calculated for three reintroduction classes (1% to 20%, 21% to 40%, and > 40%), using centers with no reintroduction (0%) as the reference group. RESULTS: Oxaliplatin reintroduction had an independent and significant impact on OS (HR = 0.56, P = .009). The percentage of patients with oxaliplatin reintroductions also had a significant impact on OS. Centers in which more than 40% of the patients were reintroduced had an adjusted HR for OS of 0.59 compared with centers in which no patient was reintroduced. CONCLUSION: Oxaliplatin reintroduction is associated with improved survival in patients with advanced colorectal cancer.
Source: PubMed
Oxaliplatin/5FU/LV in adjuvant colon cancer: Updated efficacy results of the MOSAIC trial, including survival, with a median follow-up of six years
Authors: de Gramont, A., Boni, C., Navarro, M., Tabernero, J., Hickish, T., Topham, C., Bonetti, A., Clingan, P., Lorenzato, C. and Andre, T.
Journal: JOURNAL OF CLINICAL ONCOLOGY
Volume: 25
Issue: 18
eISSN: 1527-7755
ISSN: 0732-183X
DOI: 10.1200/JCO.2006.10.4380
Source: Web of Science (Lite)
Reintroduction of oxaliplatin is associated with improved survival in advanced colorectal cancer.
Authors: de Gramont, A. et al.
Journal: Journal of clinical oncology : official journal of the American Society of Clinical Oncology
Volume: 25
Issue: 22
Pages: 3224-3229
eISSN: 1527-7755
ISSN: 0732-183X
DOI: 10.1200/jco.2006.10.4380
Abstract:Purpose
In the OPTIMOX1 trial, previously untreated patients with advanced colorectal cancer were randomly assigned to two different schedules of leucovorin, fluorouracil, and oxaliplatin that were administered until progression in the control arm or in a stop-and-go fashion in the experimental arm. The randomly assigned treatment groups did not differ significantly in terms of response rate, progression-free survival, and overall survival (OS). However, the impact of oxaliplatin reintroduction on OS was potentially masked by the fact that a large number of patients did not receive the planned oxaliplatin reintroduction or received oxaliplatin after second-line therapy in both treatment groups.Patients and methods
A Cox model was fitted with all significant baseline factors plus time-dependent variables reflecting tumor progression, reintroduction of oxaliplatin, and use of second-line irinotecan. A shared frailty model was fitted with all significant baseline factors plus the number of lines of chemotherapy received by the patient and the percentage of patients with oxaliplatin reintroduction in the center. An adjusted hazard ratio (HR) was calculated for three reintroduction classes (1% to 20%, 21% to 40%, and > 40%), using centers with no reintroduction (0%) as the reference group.Results
Oxaliplatin reintroduction had an independent and significant impact on OS (HR = 0.56, P = .009). The percentage of patients with oxaliplatin reintroductions also had a significant impact on OS. Centers in which more than 40% of the patients were reintroduced had an adjusted HR for OS of 0.59 compared with centers in which no patient was reintroduced.Conclusion
Oxaliplatin reintroduction is associated with improved survival in patients with advanced colorectal cancer.Source: Europe PubMed Central