Benefits include histopathologic downstaging, fewer incomplete resections, and better two-year disease control
By Lori Solomon HealthDay Reporter
WEDNESDAY, Feb. 1, 2023 (HealthDay News) — Six weeks of preoperative oxaliplatin-fluoropyrimidine chemotherapy is safe and effective for operable colon cancer, without increasing perioperative morbidity, according to a study published online Jan. 19 in the Journal of Clinical Oncology.
Dion Morton, M.D., from University Hospital Birmingham in the United Kingdom, and colleagues randomly assigned patients with radiologically staged T3-4, N0-2, M0 colon cancer (2:1) to six weeks oxaliplatin-fluoropyrimidine preoperatively plus 18 weeks postoperatively (neoadjuvant chemotherapy [NAC] group; 699 patients) or 24 weeks postoperatively (control group; 354 patients). Additionally, patients with RAS-wildtype tumors could also be randomly assigned (1:1) to receive panitumumab or not during NAC.
The researchers found that NAC was associated with marked T and N downstaging and histologic tumor regression. Furthermore, resection in NAC patients was more often histopathologically complete: 94 versus 89 percent. Compared with controls, fewer NAC patients had residual or recurrent disease within two years: 16.9 versus 21.5 percent (rate ratio, 0.72). There was a strong correlation between tumor regression and freedom from recurrence. There was no additional benefit observed from panitumumab with NAC, and little benefit from NAC was seen in mismatch repair-deficient tumors.
“Six weeks of NAC should be considered as a treatment option for locally advanced colon cancer,” the authors write.
Several authors disclosed financial ties to the pharmaceutical industry.
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