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Title: Reintroduction of oxaliplatin is associated with improved survival in advanced colorectal cancer
Authors: de Gramont, Aimery
BUYSE, Marc 
Quinaux, Emmanuel
Cervantes, Andres
Figer, Arie
Lledo, Gerard
Flesch, Michel
Mineur, Laurent
Carola, Elisabeth
Etienne, Pierre-Luc
Rivera, Fernando
Chirivella, Isabel
Perez-Staub, Nathalie
Louvet, Christophe
André, Thierry
Tabah-Fisch, Isabelle
Tournigand, Christophe
Issue Date: 2007
Source: JOURNAL OF CLINICAL ONCOLOGY, 25(22). p. 3224-3229
Abstract: Purpose In the OPTIMOX1 trial, previously untreated patients with advanced colorectal cancer were randomly assigned to two different schedules of leucovorin, fluorouracil, and oxaliplatin that were administered until progression in the control arm or in a stop-and-go fashion in the experimental arm. The randomly assigned treatment groups did not differ significantly in terms of response rate, progression-free survival, and overall survival ( OS). However, the impact of oxaliplatin reintroduction on OS was potentially masked by the fact that a large number of patients did not receive the planned oxaliplatin reintroduction or received oxaliplatin after second-line therapy in both treatment groups. Patients and Methods A Cox model was fitted with all significant baseline factors plus time-dependent variables reflecting tumor progression, reintroduction of oxaliplatin, and use of second-line irinotecan. A shared frailty model was fitted with all significant baseline factors plus the number of lines of chemotherapy received by the patient and the percentage of patients with oxaliplatin reintroduction in the center. An adjusted hazard ratio ( HR) was calculated for three reintroduction classes ( 1% to 20%, 21% to 40%, and > 40%), using centers with no reintroduction ( 0%) as the reference group. Results Oxaliplatin reintroduction had an independent and significant impact on OS ( HR = 0.56, P = .009). The percentage of patients with oxaliplatin reintroductions also had a significant impact on OS. Centers in which more than 40% of the patients were reintroduced had an adjusted HR for OS of 0.59 compared with centers in which no patient was reintroduced. Conclusion Oxaliplatin reintroduction is associated with improved survival in patients with advanced colorectal cancer.
Notes: Hop St Antoine, F-75571 Paris 12, France. Sanofi Aventis, Hop Tenon, Paris, France. Hop Devron, Dijon, France. Hop Senlis, Senlis, France. Int Inst Drug Dev, Louvain, Belgium. Hasselt Univ, Hasselt, Belgium. Hosp Clin Univ, Valencia, Spain. Hosp Univ Marques Valdecilla, Santander, Spain. Tel Aviv Sourasky Med Ctr, Tel Aviv, Gramont, A, Hop St Antoine, 184 Rue Faubourg St Antoine, F-75571 Paris 12,
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ISSN: 0732-183X
e-ISSN: 1527-7755
DOI: 10.1200/JCO.2006.10.4380
ISI #: 000248744000009
Category: A1
Type: Journal Contribution
Validations: ecoom 2008
Appears in Collections:Research publications

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