- Shortening oxaliplatin-based adjuvant chemotherapy (ACT) from 6 to 3 months significantly reduced long-lasting peripheral sensory neuropathy (PSN) without compromising disease-free survival (DFS) in stage III colon cancer.
Why this matters
- 3 months of therapy might be the better choice, especially in low-risk patients.
- Open-label, randomized, phase 3 ACHIEVE trial at 244 centers in Japan (n=1291).
- Patients received 3 or 6 months of ACT with capecitabine plus oxaliplatin (CAPOX) or modified fluorouracil, leucovorin, and oxaliplatin (mFOLFOX6).
- Funding: Japanese Foundation for Multidisciplinary Treatment of Cancer; Yakult Honsha.
- Initial toxicity outcomes were reported previously.
- 3-year DFS was similar in the 3- and 6-month groups (79.5% vs 77.9%; HR, 0.95; 95% CI, 0.76-1.20). There were no differences in DFS by disease risk or therapeutic regimen.
- Rate of PSN lasting for 3 years; 3 vs 6 months:
- Grade 2: 13% vs 30%.
- Grade 3: 0.9% vs 6%.
- Within-group frequency of any grade PSN lasting for 3 years was less in 3 vs 6 months:
- CAPOX: 8% vs 21% (P<.001>
- mFOLFOX6: 16% vs 34% (P<.001>
- 3 months: 8% vs 16% (P=.04).
- 6 months: 21% vs 34% (P=.02).
- Japanese population.