Less is more.

June 30 2017. The standard adjuvant therapy for stage III colon cancer has been put to the test with prelim data reported in JCO. A pre-planned pooled non-inferiority analysis of six randomized trials compared the standard 6 months with only 3 months of adjuvant oxaliplatin as part of combo chemo. The primary endpoint of disease-free survival (DFS) at 3 years for the combined 12,834 patients was 75.5% (6 months) versus 74.6% (3 months)--which did not meet pre-specified non-inferiority thresholds (we were surprised, too). Unsurprisingly, several subset analyses did show non-inferiority of the shorter regimen. Notably, 6 months had over triple the rates of neuropathy than 3 months. So with these utterly similar DFS outcomes, colon cancer patients may reasonably choose to opt out of double the adjuvant chemo...and tingly toes.


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