In randomized clinical trials, the addition of oxaliplatin to adjuvant 5-fluorouracil (5-FU) has been shown to improve survival of persons with stage III colon cancer. However, notes one investigative team, these patients are younger, healthier, and less racially diverse than cancer patients in general, rendering uncertain the benefit of oxaliplatin outside randomized clinical trials.
To learn more about the effectiveness of oxaliplatin in members of the general population with stage III colon cancer, a team led by Hanna K. Sanoff, MD, an assistant professor of medicine, hematology and oncology at the University of Virginia School of Medicine in Charlottesville, analyzed data from several cancer registries. The investigators evaluated the cases of persons younger than 75 years with stage III colon cancer who received chemotherapy within 120 days of surgical resection, comparing overall survival for 4,060 patients diagnosed during 2004–2009 with pooled data from 8,292 participants in five randomized controlled trials.
As the researchers reported in Journal of the National Cancer Institute, the survival advantage seen with the addition of oxaliplatin to adjuvant 5-FU was just as evident outside of the trials as within. The combined therapy was associated with improved survival across various practice settings, including those with older patients, minority patients, and patients with greater comorbidity. For example, for patients receiving oxaliplatin in addition to 5-FU, the 3-year overall survival rate in randomized controlled trials was 86%, comparable to the 80% 3-year overall survival rate for patients who were part of the Medicare-based Surveillance, Epidemiology and End Results (SEER) registry and the 86% rate for patients included in the National Comprehensive Cancer Network database.