Colon to Rectum

J Clin Oncol. 2023;41(4):803–15

Gallois C, Shi Q, Meyers JP, Iveson T, Alberts SR, de Gramont A, Sobrero AF, Haller DG, Oki E, Shields AF, Goldberg RM, Kerr R, Lonardi S, Yothers G, Kelly C, Boukovinas I, Labianca R, Sinicrope FA, Souglakos I, Yoshino T, Meyerhardt JA, André T, Papamichael D, Taieb J

Prognostic impact of early treatment and oxaliplatin discontinuation in patients with stage III colon cancer: An ACCENT/IDEA pooled analysis of 11 adjuvant trials

Purpose: Oxaliplatin-based adjuvant chemotherapy in patients with stage III colon cancer (CC) for 6 months remains a standard in high-risk stage III patients. Data are lacking as to whether early discontinuation of all treatment (ETD) or early discontinuation of oxaliplatin (EOD) could worsen the prognosis.
Materials and methods: The authors studied the prognostic impact of ETD and EOD in patients with stage III CC from the ACCENT/IDEA databases, where patients were planned to receive 6 months of infusional fluorouracil, leucovorin, and oxaliplatin or capecitabine plus oxaliplatin. ETD was defined as discontinuation of treatment and EOD as discontinuation of oxaliplatin only before patients had received a maximum of 75% of planned cycles. Association between ETD/EOD and overall survival (OS) and disease-free survival (DFS) were assessed by Cox models adjusted for established prognostic factors.
Results: Analysis of ETD and EOD included 10,447 (20.9% with ETD) and 7243 (18.8% with EOD) patients, respectively. Compared with patients without ETD or EOD, patients with ETD or EOD were statistically more likely to be women, with Eastern Cooperative Oncology Group performance status ≥ 1, and for ETD, older with a lower body mass index. In multivariable analyses, ETD was associated with a decrease in DFS and OS (hazard ratio [HR] = 1.61, p < 0.001 and HR = 1.73, p < 0.001), which was not the case for EOD (HR = 1.07, p = 0.3 and HR = 1.13, p = 0.1). However, patients who received < 50% of the planned cycles of oxaliplatin had poorer outcomes.

Conclusion: In patients treated with 6 months of oxaliplatin-based chemotherapy for stage III colon cancer, early discontinuation of all treatment was associated with poorer oncologic outcomes. However, this was not the case for early discontinuation of oxaliplatin. These data favor discontinuing oxaliplatin while continuing fluoropyrimidine in individuals with significant neurotoxicity having received > 50% of the planned 6-month chemotherapy.

Prof. Dr. J. Taieb, Department of Gastroenterology and Digestive Oncology, Hôpital Européen Georges Pompidou, Université Paris-Cité, Paris, France,
E-Mail: jtaieb75@gmail.com

DOI: DOI: 10.1200/jco.21.02726

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Colon to Rectum

Long-term gastrointestinal sequelae following COVID-19: A prospective follow-up cohort study

Clin Gastroenterol Hepatol. 2023;21(3):789–96.e1

Colon to Rectum

Post-COVID-19 irritable bowel syndrome

Gut. 2023;72(3):484–92

Marasco G, Cremon C, Barbaro MR, Cacciari G, Falangone F, Kagramanova A, Bordin D, Drug V, Miftode E, Fusaroli P, Mohamed SY, Ricci C, Bellini M, Rahman MM, Melcarne L, Santos J, Lobo B, Bor S, Yapali S, Akyol D, Sapmaz FP, Urun YY, Eskazan T, Celebi A, Kacmaz H, Ebik B, Binicier HC, Bugdayci MS, Yağcı MB, Pullukcu H, Kaya BY, Tureyen A, Hatemi İ, Koc ES, Sirin G, Calıskan AR, Bengi G, Alıs EE, Lukic S, Trajkovska M, Hod K, Dumitrascu D, Pietrangelo A, Corradini E, Simren M, Sjölund J, Tornkvist N, Ghoshal UC, Kolokolnikova O, Colecchia A, Serra J, Maconi G, De Giorgio R, Danese S, Portincasa P, Di Sabatino A, Maggio M, Philippou E, Lee YY, Salvi D, Venturi A, Borghi C, Zoli M, Gionchetti P, Viale P, Stanghellini V, Barbara G; GI-COVID19 study group

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