S-1 and Oxaliplatin Versus Tegafur-uracil and Leucovorin as Postoperative Adjuvant Chemotherapy in Patients With High-risk Stage III Colon Cancer (ACTS-CC 02): A Randomized, Open-label, Multicenter, Phase III Superiority Trial.


Journal

Clinical colorectal cancer
ISSN: 1938-0674
Titre abrégé: Clin Colorectal Cancer
Pays: United States
ID NLM: 101120693

Informations de publication

Date de publication:
03 2020
Historique:
received: 30 07 2019
revised: 27 09 2019
accepted: 11 10 2019
pubmed: 10 1 2020
medline: 11 5 2021
entrez: 10 1 2020
Statut: ppublish

Résumé

The efficacy of S-1 plus oxaliplatin (SOX) as postoperative adjuvant chemotherapy for colon cancer has not been established. This randomized phase III study was designed to verify the superiority of SOX over tegafur-uracil and leucovorin (UFT/LV) in patients with high-risk stage III colon cancer (any T, N2, or positive nodes around the origin of the feeding arteries). Patients who underwent curative resection for pathologically confirmed high-risk stage III colon cancer were randomly assigned to receive either UFT/LV (300 mg/m A total of 478 patients in the UFT/LV group and 477 patients in the SOX group were included in the primary analysis. The 3-year DFS was 60.6% (95% confidence interval [CI], 56.0%-64.9%) in the UFT/LV group and 62.7% (95% CI, 58.1%-66.9%) in the SOX group. The stratified hazard ratio for DFS was 0.90 (95% CI, 0.74-1.09; stratified log-rank test, P = .2780). In the N2b subgroup, the 3-year DFS was 46.0% (95% CI, 37.5%-54.0%) in the UFT/LV group and 54.7% (95% CI, 45.7%-62.7%) in the SOX group (hazard ratio, 0.76; 95% CI, 0.55-1.05). As postoperative adjuvant chemotherapy, SOX was not superior to UFT/LV in terms of DFS in patients with high-risk stage III colon cancer.

Sections du résumé

BACKGROUND
The efficacy of S-1 plus oxaliplatin (SOX) as postoperative adjuvant chemotherapy for colon cancer has not been established. This randomized phase III study was designed to verify the superiority of SOX over tegafur-uracil and leucovorin (UFT/LV) in patients with high-risk stage III colon cancer (any T, N2, or positive nodes around the origin of the feeding arteries).
PATIENTS AND METHODS
Patients who underwent curative resection for pathologically confirmed high-risk stage III colon cancer were randomly assigned to receive either UFT/LV (300 mg/m
RESULTS
A total of 478 patients in the UFT/LV group and 477 patients in the SOX group were included in the primary analysis. The 3-year DFS was 60.6% (95% confidence interval [CI], 56.0%-64.9%) in the UFT/LV group and 62.7% (95% CI, 58.1%-66.9%) in the SOX group. The stratified hazard ratio for DFS was 0.90 (95% CI, 0.74-1.09; stratified log-rank test, P = .2780). In the N2b subgroup, the 3-year DFS was 46.0% (95% CI, 37.5%-54.0%) in the UFT/LV group and 54.7% (95% CI, 45.7%-62.7%) in the SOX group (hazard ratio, 0.76; 95% CI, 0.55-1.05).
CONCLUSION
As postoperative adjuvant chemotherapy, SOX was not superior to UFT/LV in terms of DFS in patients with high-risk stage III colon cancer.

Identifiants

pubmed: 31917122
pii: S1533-0028(19)30449-9
doi: 10.1016/j.clcc.2019.10.002
pii:
doi:

Substances chimiques

Drug Combinations 0
Oxaliplatin 04ZR38536J
S 1 (combination) 150863-82-4
Tegafur 1548R74NSZ
Oxonic Acid 5VT6420TIG
Leucovorin Q573I9DVLP

Types de publication

Clinical Trial, Phase III Equivalence Trial Journal Article Multicenter Study Randomized Controlled Trial Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

22-31.e6

Commentaires et corrections

Type : CommentIn
Type : CommentIn

Informations de copyright

Copyright © 2019 The Author(s). Published by Elsevier Inc. All rights reserved.

Auteurs

Eiji Sunami (E)

Department of Surgical Oncology, Japanese Red Cross Medical Center, Tokyo, Japan. Electronic address: eijisunami@yahoo.co.jp.

Tetsuya Kusumoto (T)

Department of Gastrointestinal Surgery and Clinical Research Institute, Cancer Research Division, National Kyushu Medical Center, Fukuoka, Japan.

Mitsuyoshi Ota (M)

Gastroentelorogical Center, Yokohama City University Medical Center, Kanagawa, Japan.

Yoshiyuki Sakamoto (Y)

Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, Aomori, Japan.

Kazuhiro Yoshida (K)

Department of Surgical Oncology, Gifu University Graduate School of Medicine, Gifu, Japan.

Naohiro Tomita (N)

Division of Lower GI Surgery, Department of Surgery, Hyogo College of Medicine, Hyogo, Japan.

Atsuyuki Maeda (A)

Department of Surgery, Ogaki Municipal Hospital, Gifu, Japan.

Jin Teshima (J)

Department of Gastrointestinal Surgery, Iwate Prefectural Central Hospital, Iwate, Japan.

Michio Okabe (M)

Department of General Surgery, Kurashiki Central Hospital, Okayama, Japan.

Chihiro Tanaka (C)

Department of Surgery, Gifu Prefectural General Medical Center, Gifu, Japan.

Junichiro Yamauchi (J)

Department of Surgery, Sendai Kousei Hospital, Miyagi, Japan.

Michio Itabashi (M)

Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan.

Kenjiro Kotake (K)

Department of Surgery, Tochigi Cancer Center, Tochigi, Japan.

Keiichi Takahashi (K)

Department of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan.

Hideo Baba (H)

Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.

Narikazu Boku (N)

Division of Gastrointestinal Medical Oncology, National Cancer Center Hospital, Tokyo, Japan.

Keisuke Aiba (K)

Department of Internal Medicine, Division of Clinical Oncology/Hematology, The Tokyo Jikei University School of Medicine, Tokyo, Japan.

Megumi Ishiguro (M)

Department of Chemotherapy and Oncosurgery, Tokyo Medical and Dental University Medical Hospital, Tokyo, Japan.

Satoshi Morita (S)

Department of Biomedical Statistics and Bioinformatics, Kyoto University Graduate School of Medicine, Kyoto, Japan.

Naruhito Takenaka (N)

Medical Affairs Division, Taiho Pharmaceutical Co, Ltd, Tokyo, Japan.

Ryota Okude (R)

Medical Affairs Division, Taiho Pharmaceutical Co, Ltd, Tokyo, Japan.

Kenichi Sugihara (K)

Tokyo Medical and Dental University, Tokyo, Japan.

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