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Duration of FOLFOX Adjuvant Chemotherapy in High-Risk Stage II and Stage III Colon Cancer With Deficient Mismatch Repair

BACKGROUND: We evaluated the impact of 3 months of mFOLFOX6 adjuvant chemotherapy or surgery alone in comparison with 6 months of mFOLFOX6 on disease-free survival (DFS) in deficient mismatch repair (dMMR) colon cancer (CC) patients. METHODS: This retrospective study identified a cohort of patients...

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Autores principales: Hu, Huabin, Wu, Zehua, Wang, Chao, Huang, Yan, Zhang, Jianwei, Cai, Yue, Xie, Xiaoyu, Li, Jianxia, Shen, Cailu, Li, Weiwei, Ling, Jiayu, Xu, Xuehu, Deng, Yanhong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7747753/
https://www.ncbi.nlm.nih.gov/pubmed/33344234
http://dx.doi.org/10.3389/fonc.2020.579478
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author Hu, Huabin
Wu, Zehua
Wang, Chao
Huang, Yan
Zhang, Jianwei
Cai, Yue
Xie, Xiaoyu
Li, Jianxia
Shen, Cailu
Li, Weiwei
Ling, Jiayu
Xu, Xuehu
Deng, Yanhong
author_facet Hu, Huabin
Wu, Zehua
Wang, Chao
Huang, Yan
Zhang, Jianwei
Cai, Yue
Xie, Xiaoyu
Li, Jianxia
Shen, Cailu
Li, Weiwei
Ling, Jiayu
Xu, Xuehu
Deng, Yanhong
author_sort Hu, Huabin
collection PubMed
description BACKGROUND: We evaluated the impact of 3 months of mFOLFOX6 adjuvant chemotherapy or surgery alone in comparison with 6 months of mFOLFOX6 on disease-free survival (DFS) in deficient mismatch repair (dMMR) colon cancer (CC) patients. METHODS: This retrospective study identified a cohort of patients with high-risk stage II and III dMMR CC who underwent curative surgery between May 2011 and July 2019. DFS was compared using the Kaplan-Meier survival methods and Cox proportional hazards models. Propensity-score matching was performed to reduce imbalance in baseline characteristics. RESULTS: A total of 242 dMMR CC patients were identified; 66 patients received 6 months of mFOLFOX6, 87 patients received 3 months of mFOLFOX6, and 89 patients were treated with surgery alone. The 3-year DFS rate was 72.8% in 3-month therapy group and 86.1% in 6-month therapy group, with a hazard ratio (HR) of 2.78 (95CI%, 1.18 to 6.47; P= 0.019). The difference in DFS between surgery alone group and 6-month therapy group was also observed but was nonsignificant (HR= 2.30, 95%CI, 0.99 to 5.38; P=0.054). The benefit of 6-month therapy in DFS compared with 3-month therapy group was pronounced for patients with stage III (HR=2.81, 95%CI, 1.03 to 7.67; P=0.044) but not for high-risk stage II patients. Propensity score matched analysis confirmed a DFS benefit in the 6-month therapy group. CONCLUSION: This study suggested that a 6-month duration of mFOLFOX6 adjuvant chemotherapy in dMMR CC patients may be associated with improved DFS compared with 3-month therapy, particularly in patients with stage III. The observational nature of the study implies caution should be taken in the interpretation of these results.
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spelling pubmed-77477532020-12-19 Duration of FOLFOX Adjuvant Chemotherapy in High-Risk Stage II and Stage III Colon Cancer With Deficient Mismatch Repair Hu, Huabin Wu, Zehua Wang, Chao Huang, Yan Zhang, Jianwei Cai, Yue Xie, Xiaoyu Li, Jianxia Shen, Cailu Li, Weiwei Ling, Jiayu Xu, Xuehu Deng, Yanhong Front Oncol Oncology BACKGROUND: We evaluated the impact of 3 months of mFOLFOX6 adjuvant chemotherapy or surgery alone in comparison with 6 months of mFOLFOX6 on disease-free survival (DFS) in deficient mismatch repair (dMMR) colon cancer (CC) patients. METHODS: This retrospective study identified a cohort of patients with high-risk stage II and III dMMR CC who underwent curative surgery between May 2011 and July 2019. DFS was compared using the Kaplan-Meier survival methods and Cox proportional hazards models. Propensity-score matching was performed to reduce imbalance in baseline characteristics. RESULTS: A total of 242 dMMR CC patients were identified; 66 patients received 6 months of mFOLFOX6, 87 patients received 3 months of mFOLFOX6, and 89 patients were treated with surgery alone. The 3-year DFS rate was 72.8% in 3-month therapy group and 86.1% in 6-month therapy group, with a hazard ratio (HR) of 2.78 (95CI%, 1.18 to 6.47; P= 0.019). The difference in DFS between surgery alone group and 6-month therapy group was also observed but was nonsignificant (HR= 2.30, 95%CI, 0.99 to 5.38; P=0.054). The benefit of 6-month therapy in DFS compared with 3-month therapy group was pronounced for patients with stage III (HR=2.81, 95%CI, 1.03 to 7.67; P=0.044) but not for high-risk stage II patients. Propensity score matched analysis confirmed a DFS benefit in the 6-month therapy group. CONCLUSION: This study suggested that a 6-month duration of mFOLFOX6 adjuvant chemotherapy in dMMR CC patients may be associated with improved DFS compared with 3-month therapy, particularly in patients with stage III. The observational nature of the study implies caution should be taken in the interpretation of these results. Frontiers Media S.A. 2020-12-04 /pmc/articles/PMC7747753/ /pubmed/33344234 http://dx.doi.org/10.3389/fonc.2020.579478 Text en Copyright © 2020 Hu, Wu, Wang, Huang, Zhang, Cai, Xie, Li, Shen, Li, Ling, Xu and Deng http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
Hu, Huabin
Wu, Zehua
Wang, Chao
Huang, Yan
Zhang, Jianwei
Cai, Yue
Xie, Xiaoyu
Li, Jianxia
Shen, Cailu
Li, Weiwei
Ling, Jiayu
Xu, Xuehu
Deng, Yanhong
Duration of FOLFOX Adjuvant Chemotherapy in High-Risk Stage II and Stage III Colon Cancer With Deficient Mismatch Repair
title Duration of FOLFOX Adjuvant Chemotherapy in High-Risk Stage II and Stage III Colon Cancer With Deficient Mismatch Repair
title_full Duration of FOLFOX Adjuvant Chemotherapy in High-Risk Stage II and Stage III Colon Cancer With Deficient Mismatch Repair
title_fullStr Duration of FOLFOX Adjuvant Chemotherapy in High-Risk Stage II and Stage III Colon Cancer With Deficient Mismatch Repair
title_full_unstemmed Duration of FOLFOX Adjuvant Chemotherapy in High-Risk Stage II and Stage III Colon Cancer With Deficient Mismatch Repair
title_short Duration of FOLFOX Adjuvant Chemotherapy in High-Risk Stage II and Stage III Colon Cancer With Deficient Mismatch Repair
title_sort duration of folfox adjuvant chemotherapy in high-risk stage ii and stage iii colon cancer with deficient mismatch repair
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7747753/
https://www.ncbi.nlm.nih.gov/pubmed/33344234
http://dx.doi.org/10.3389/fonc.2020.579478
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