Impact of the IDEA Collaboration Study Results on Clinical Practice in France for Patients With Stage III Colon Cancer: A National GERCOR - PRODIGE Survey

Ouali, Kaïssa; Turpin, Anthony; Neuzillet, Cindy; Rousseau, Benoît; Garcia-Larnicol, Marie-Line; Tournigand, Christophe; Samalin, Emmanuelle; Taı̈eb, Julien; Thewis, André; Cohen, Romain

doi:10.1016/j.clcc.2020.11.004

Cited by 5 publications

(5 citation statements)

References 14 publications

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“…This survey has contributed to understanding the impact of the IDEA collaboration on clinician-prescribing practices soon after first publication of the IDEA results in abstract form. Other surveys of clinicians’ opinions have been performed ( 14 , 15 ) but with fewer respondents and from different locations. The strengths of this survey are the high number of responses and the timeliness with which it was disseminated after the IDEA collaboration results were publicized, only 4 months after the initial conference presentation.…”

Section: Discussionmentioning

confidence: 99%

The Early Impact of the IDEA Collaboration Results: How the Results Changed Prescribing Practice

Iveson

Hanna²,

Zhang

et al. 2021

JNCI Cancer Spectrum

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Background Traditionally, adjuvant treatment for colon cancer has been 6 months of combination chemotherapy. Six phase III trials tested the hypothesis that 3 months is non-inferior in efficacy to 6 months and reduces long-term side effects for patients. The results were pooled in the International Duration Evaluation of Adjuvant therapy (IDEA) collaboration. Although this did not meet the non-inferiority endpoint, a pre-planned subgroup analysis by chemotherapy regimen did demonstrate non-inferiority for capecitabine and oxaliplatin (CAPOX). Additionally, risk stratification by T and N stage was defined. Methods In an effort to understand the real-life impact of these results, four months after the IDEA results, an online survey was distributed to clinicians to ask their approach to the adjuvant treatment of patients with stage III colon cancer. Results The survey was completed by 458 clinicians from 12 countries. Assuming that 6 months of treatment was the pre-trial standard of care, 89.5% of clinicians reported they had changed practice to prescribe 3 months of treatment for some patients. For patients with low-risk stage III disease, there was a preference for 3 months and for patients with high-risk stage III disease, most clinicians still prescribed 6 months at that time. Overall, CAPOX was the most popular regimen. There were important differences in responses depending on the location of respondent and T and N stage of disease. Conclusion This survey shows that the IDEA collaboration was been practice changing but reveals important differences in the way results are interpreted by individual clinicians.

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Section: Discussionmentioning

confidence: 99%

The Early Impact of the IDEA Collaboration Results: How the Results Changed Prescribing Practice

Iveson

Hanna²,

Zhang

et al. 2021

JNCI Cancer Spectrum

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“…In a survey of over 200 physicians, Ouali et al reported that 81% of participants agreed that 3 months of AC was the new standard for low-risk stage III colon cancer. 31 Similarly, Yu et al surveyed 145 international physicians, reporting that 68% agreed with the same statement. 32 Importantly, our results demonstrate that T4 and N2 staging were independent predictors of recurrence and mortality, supporting the IDEA-based risk stratification system.…”

Section: Discussionmentioning

confidence: 97%

“…In a survey of over 200 physicians, Ouali et al. reported that 81% of participants agreed that 3 months of AC was the new standard for low‐risk stage III colon cancer 31 . Similarly, Yu et al.…”

Section: Discussionmentioning

confidence: 97%

Real‐world adjuvant chemotherapy treatment patterns and outcomes over time for resected stage II and III colorectal cancer

Degeling

McCoy

et al. 2022

Asia-Pac J Clncl Oncology

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Section: Introductionmentioning

confidence: 99%

“…Thus, in patients with low-risk stage III CC, 3 months of CAPOX has become a standard of care (FOLFOX 3 or 6 months as options), whereas 6 months of FOLFOX (or CAPOX for 3 or 6 months as options) is recommended to patients with T4 and/or N2 tumors. [10][11][12] In patients receiving 6 months of adjuvant chemotherapy, early treatment termination has been reported for about a third of patients 1,[13][14][15][16][17] with a negative prognostic impact on OS in most studies, except for one retrospective study including 616 patients treated with FOLFOX, which reported no impact on survival outcomes. 18 In current clinical practice, oxaliplatin is also often stopped early because of cumulative peripheral sensory neurotoxicity, and we have no data on the prognostic impact of early oxaliplatin discontinuation (EOD) while continuing fluoropyrimidine in patients with localized CC.…”

Section: Introductionmentioning

confidence: 99%

Prognostic Impact of Early Treatment and Oxaliplatin Discontinuation in Patients With Stage III Colon Cancer: An ACCENT/IDEA Pooled Analysis of 11 Adjuvant Trials

Gallois

Meyers

Iveson

et al. 2023

JCO

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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 We 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 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 7,243 (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 disease-free survival and overall survival (hazard ratio [HR]: 1.61, P < .001 and HR: 1.73, P < .001), which was not the case for EOD (HR: 1.07, P = .3 and HR: 1.13, P = .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 CC, ETD was associated with poorer oncologic outcomes. However, this was not the case for EOD. These data favor discontinuing oxaliplatin while continuing fluoropyrimidine in individuals with significant neurotoxicity having received > 50% of the planned 6-month chemotherapy.

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Impact of the IDEA Collaboration Study Results on Clinical Practice in France for Patients With Stage III Colon Cancer: A National GERCOR - PRODIGE Survey

Cited by 5 publications

References 14 publications

The Early Impact of the IDEA Collaboration Results: How the Results Changed Prescribing Practice

The Early Impact of the IDEA Collaboration Results: How the Results Changed Prescribing Practice

Real‐world adjuvant chemotherapy treatment patterns and outcomes over time for resected stage II and III colorectal cancer

Prognostic Impact of Early Treatment and Oxaliplatin Discontinuation in Patients With Stage III Colon Cancer: An ACCENT/IDEA Pooled Analysis of 11 Adjuvant Trials

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