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Shorter Duration of Adjuvant Therapy Does Not Compromise Efficacy in Colon Cancer: ACHIEVE Trial
In Asian patients with curatively resected stage III colon cancer, shortening adjuvant fluorouracil, leucovorin, and oxaliplatin (FOLFOX) or capecitabine and oxaliplatin (CAPOX) therapy from 6 to 3 months did not compromise efficacy, according to an analysis published in Journal of Clinical Oncology.
Takayuki Yoshino, MD, PhD, Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan et al reported the final analyses and long-term safety of the phase III ACHIEVE trial, a multicenter, open-label, randomized trial conducted in Japan.
A total of 1291 patients were included in the study. Patients were randomized in a 1:1 ratio to receive 6 months (n = 641) or 3 months (n = 650) of adjuvant treatment with physician’s choice of modified FOLFOX6 or CAPOX.
The primary study end point was disease-free survival (DFS), assessed in the modified intention-to-treat population. Overall survival (OS) was a secondary end point.
Median follow-up for this analysis was 74.7 months. The 5-year OS was 87% in the 3-month treatment group and 86.4% in the 6-month treatment group (hazard ratio, 0.91; 95% CI, 0.69 to 1.20; P = .51).
The 6-month treatment group experienced higher incidence of peripheral sensory neuropathy lasting longer than 5 years vs the 3-month treatment group (16% vs 8%, respectively). In addition, those who received modified FOLFOX6 compared with CAPOX (14% vs 11%, respectively).
“In Asian patients, shortening adjuvant therapy duration from 6 to 3 months did not compromise efficacy and reduced the rate of long-lasting peripheral sensory neuropathy,” concluded Dr Yoshino.
The investigators added that in this setting, 3 months of CAPOX therapy is an appropriate adjuvant treatment option, particularly in patients with low-risk disease.
Source:
Yoshino T, Oki E, Misumi T, et al. Final Analysis of 3 Versus 6 Months of Adjuvant Oxaliplatin and Fluoropyrimidine-Based Therapy in Patients With Stage III Colon Cancer: The Randomized Phase III ACHIEVE Trial. J Clin Oncol. 2022;JCO2102628. doi:10.1200/JCO.21.02628
