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Efficacy and long-term peripheral sensory neuropathy of 3 vs 6 months of oxaliplatin-based adjuvant chemotherapy for colon cancer: The ACHIEVE phase 3 randomized clinical trial

JAMA Nov 25, 2019

Yoshino T, Yamanaka T, Oki E, et al. - Among 1,313 patients with stage III colon cancer treated with 3 vs 6 months of adjuvant oxaliplatin-based chemotherapy, researchers conducted an open-label, multicenter, phase 3 randomized clinical trial to evaluate disease-free survival (DFS) and long-lasting peripheral sensory neuropathy (PSN). The chemotherapy regimen was selected at the discretion of the treating physician: modified fluorouracil, leucovorin, and oxaliplatin (mFOLFOX6) or capecitabine plus oxaliplatin (CAPOX). For DFS, the estimated hazard ratio (HR) of the 3-month arm vs the 6-month arm was 0.95. For mFOLFOX6 and CAPOX, the HRs were estimated to be 1.07 and 0.90, respectively. A significantly lower incidence of long-lasting PSN was reported in correlation with 3 months vs 6 months of therapy, as well as in relation to treatment with the drug CAPOX vs with mFOLFOX6. Since the shortened therapy period did not compromise performance, the most appropriate treatment choice may be a 3-month CAPOX course, especially for patients with low-risk disease.
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