QUASAR: A randomized study of adjuvant chemotherapy (CT) vs observation including 3238 colorectal cancer patients

Gray, Richard; Barnwell, J.; Hills, Robert Kerrin; McConkey, Christopher C.; Williams, Nerys; Kerr, D. J.

doi:10.1200/jco.2004.22.14_suppl.3501

Cited by 52 publications

(10 citation statements)

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“…A retrospective subset analysis of four consecutive National Surgical Adjuvant Breast and Bowel Project (NSABP) trials noted a similar proportional survival benefit for Stage II and Stage III patients who received fluorouracil‐based therapy, leading the authors to recommend adjuvant treatment for patients with both Stage II and III colon cancer 91 . Results from the Quick and Simple and Reliable (QUASAR) study, a complex comparison of four different fluorouracil‐based regimens with observation alone in a heterogeneous patient population, support a marginal survival benefit for patients with Stage II colon and rectal cancer; these results have thus far been reported only in abstract form 92 …”

Section: Colon Cancermentioning

confidence: 99%

Adjuvant Treatment of Colorectal Cancer

Wolpin

Meyerhardt

Mamon

et al. 2007

CA: A Cancer Journal for Clinicians

240

214

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Colorectal cancer is the fourth most common noncutaneous malignancy in the United States and the second most frequent cause of cancer-related death. Approximately three quarters of patients are diagnosed with disease limited to the bowel wall or surrounding lymph nodes. Over the past decade, significant progress has been made in the treatment of localized colorectal cancer due to advances in surgery, radiotherapy, and chemotherapy. For patients with Stage III colon cancer, an overall survival benefit for fluorouracil-based chemotherapy has been firmly established, and recent data have shown further efficacy through the inclusion of oxaliplatin into adjuvant treatment programs. For patients with Stage II colon cancer, the use of adjuvant chemotherapy remains controversial, but may be appropriate in a subset of individuals at high risk for disease recurrence. In the treatment of patients with rectal cancer, improved outcomes have been noted with the use of total mesorectal excision and preoperative concurrent chemoradiotherapy. Current randomized clinical trials in the adjuvant therapy of colorectal cancer are examining the value of adding agents known to be active in metastatic disease, including those that modify specific molecular targets. (CA Cancer J Clin 2007;57:168-185.)

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Section: Colon Cancermentioning

confidence: 99%

Adjuvant Treatment of Colorectal Cancer

Wolpin

Meyerhardt

Mamon

et al. 2007

CA: A Cancer Journal for Clinicians

240

214

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“…1 In a pooled-analysis, fluorouracil (FU)-based chemotherapy was shown to increase the 5-year OS from 64% to 71% in a mixed group of node-negative (American Joint Committee on Cancer stage II) and node-positive (American Joint Committee on Cancer stage III) patients. 3 However, two large studies (one randomized clinical trial 4 and one pooled analysis of seven randomized clinical trials 5 ) have both suggested a modest but consistent treatment benefit from FU-based chemotherapy in these patients. 3 However, two large studies (one randomized clinical trial 4 and one pooled analysis of seven randomized clinical trials 5 ) have both suggested a modest but consistent treatment benefit from FU-based chemotherapy in these patients.…”

Section: Introductionmentioning

confidence: 99%

Disease-Free Survival Versus Overall Survival As a Primary End Point for Adjuvant Colon Cancer Studies: Individual Patient Data From 20,898 Patients on 18 Randomized Trials

Sargent

Wieand

Haller

et al. 2005

JCO

610

381

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In patients treated on phase III adjuvant colon clinical trials, DFS and OS are highly correlated, both within patients and across trials. These results suggest that DFS after 3 years of median follow-up is an appropriate end point for adjuvant colon cancer clinical trials of fluorouracil-based regimens, although marginally significant DFS improvements may not translate into significant OS benefits.

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“…The first evidence for the benefit of adjuvant chemotherapy in stage II disease comes from the QUASAR study that randomised 3238 patients to either fluorouracil-leucovorin or follow up after R0 resection (91% stage II, 71% colon cancer) over a period of nine years. 30 The rate of recurrence after five years was 22.2% in the treatment group and 26.2% in the control group. Five year overall survival was 80.3% versus 77.4%.…”

Section: Treatment Of Stage II Diseasementioning

confidence: 85%