The hope for today--the promise for tomorrow: will oncologists meet the challenge? Clinical Oncology

摘要

The dawn of this century is witness to a paradigm of new treatment strategies for patients with colorectal cancer offering renewed hope for thousands of individuals. Hope is characteristically accompanied by the challenge of potentiating newly acquired gains. Advances should indeed form the construct of the next path toward additional change. In this issue of the Journal of Clinical Oncology, the National Surgical Adjuvant Breast and Bowel Project (NSABP) reports the results from study C-07, demonstrating the 3- and 4-year disease-free-survival (DFS) advantage for stage II and III colon cancer patients who received oxaliplatin combined with weekly bolus fluorouracil (FU) and leucovorin (FLOX) compared with those treated with the weekly bolus FU and leucovorin schedule known as the Roswell Park regimen, the control arm of previous studies.1 These results clearly redefine the superiority of an oxaliplatin-based regimen for adjuvant colon cancer therapy and confirm the results of the Adjuvant Treatment ofColon Cancer (MOSAIC) trial, which used the more widely embraced FU, leucovorin, and oxaliplatin (FOLFOX4) regimen using a continuous-infusion FU schedule.2 The 3- and 4-year DFS (76.1% v 78.2% at 3 years) and the percent difference in the 4-year DFS (6.2% v 6.6%) are similar for FLOX (C-07) and FOLFOX4 (MOSAIC), respectively. The two comparator arms for both trials, bolus FU (NSABP C-07) versus infusion FU (MOSAIC), have been widely used in the past and also resulted in a comparable DFS (71.8% v 72.9% at 3 years).