A shorter mFOLFOX/CAPOX treatment is effective and safe for patients with stage 2 colon cancer

This study compared 3 and 6 months of oxaliplatin (Eloxatin)-based chemotherapy in stage 2 colon cancer. Researchers suggested that the 3-month treatment might be a good and safer option for these patients.

Colorectal cancer is the third most common cancer diagnosed in both men and women in the US. Chemotherapy after surgery is the standard care for patients with stage 3 colon cancer. However, the effectiveness of this treatment in high-risk stage 2 colon cancer is still not clear. The risk of stage 2 colon cancer lies in the possibility of progression to level 3 which includes spread to the lymph nodes.

Prior studies confirmed the effectiveness of FOLFOX (5-fluorouracil, leucovorin, and oxaliplatin) or CAPOX (capecitabine and oxaliplatin) in high-risk stage 2 colon cancer. However, many patients develop peripheral sensory neuropathy (weakness, numbness, and pain in the hands and feet) during the 6 months of this therapy. It affects the performance of daily activities and the quality of life of these patients. It is still not clear if a 3-month treatment has similar effectiveness with a lower occurrence of sensory neuropathy.

This study included 514 Asian patients with high-risk stage 2 colon cancer. These patients were assigned to receive 3 months (255) or 6 months (259) therapy with mFOLFOX or CAPOX. Of all participants, 432 (84%) received CAPOX. 184 (36%) presented a high risk for recurrence (when cancer comes back).

88.2% of the patients in the 3-month group and 87.9% in the 6-month group were alive after 3 years without the return of the disease. In the CAPOX group, the 3-year survival rate without cancer was 88.2% for the 3-month therapy and 88.4% for the 6- month therapy.

In the mFOLFOX group, 10% of patients on the 3-month therapy stopped their treatment due to toxicity. This was compared to 31% in the 6- month group. In the CAPOX group, 15% in the 3-month group stopped their treatment, compared to 35% in the 6-month group.

Overall, sensory neuropathy was reported in 16% of patients on the 3-month treatment, compared to 43% in the 6-month group.

This study confirmed the effectiveness and improved safety of a 3-month treatment with oxaliplatin-based chemotherapy of patients with stage 2 colon cancer.