Phase III Study Comparing a Semimonthly With a Monthly Regimen of Fluorouracil and Leucovorin As Adjuvant Treatment for Stage II and III Colon Cancer Patients: Final Results of GERCOR C96.1

André, Thierry; Quinaux, Emmanuel; Louvet, Christophe; Colin, Philippe; Gamelin, E.; Bouché, Olivier; Achille, Emmanuel; Piedbois, Pascal; Tubiana-Mathieu, Nicole; Boutan-Laroze, Arnaud; Flesch, M.; Lledo, Gérard; Raoul, Y.; Debrix, Isabelle; Buyse, Marc; Gramont, Aimery de

doi:10.1200/jco.2007.12.2234

Cited by 135 publications

(74 citation statements)

References 21 publications

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“…Developing improved prognostic tools is important as the current array of clinical predictors provides only broad categorizations of risk and insufficiently characterizes the relative risk for recurrence in individual patients (7). As an example, patients with early stage colon cancer (stages I and II) are usually considered cured after surgical resection, despite the fact that 15-20% of these patients develop disease recurrence (8,9). In breast and lung cancer (10)(11)(12), genomic approaches have been shown to direct the care of cancer patients.…”

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confidence: 99%

RETRACTED: A genomic approach to colon cancer risk stratification yields biologic insights into therapeutic opportunities

Garman¹,

Acharya²,

Grade

et al. 2008

Proc. Natl. Acad. Sci. U.S.A.

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Gene expression profiles provide an opportunity to dissect the heterogeneity of solid tumors, including colon cancer, to improve prognosis and predict response to therapies. Bayesian binary regression methods were used to generate a signature of disease recurrence in patients with resected early stage colon cancer validated in an independent cohort. A 50-gene signature was developed that effectively distinguished early stage colon cancer patients with a low or high risk of disease recurrence. RT-PCR analysis of the 50-gene signature validated 9 of the top 10 differentially expressed genes. When applied to two independent validation cohorts of 55 and 73 patients, the 50-gene model accurately predicted recurrence. Standard Kaplan–Meier survival analysis confirmed the prognostic accuracy ( P < 0.01, log rank), as did multivariate Cox proportional hazard models. We tested potential targeted therapeutic options for patients at high risk for disease recurrence and found a clinically important relationship between sensitivity to celecoxib, LY-294002 (PI3kinase inhibitor), retinol, and sulindac in colon cancer cell lines expressing the poor prognostic phenotype ( P < 0.01, t test), which performed better than standard chemotherapy (5-FU and oxaliplatin). We present a genomic strategy in early stage colon cancer to identify patients at highest risk of recurrence. An ability to move beyond current staging by refining the estimation of prognosis in early stage colon cancer also has implications for individualized therapy.

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mentioning

confidence: 99%

RETRACTED: A genomic approach to colon cancer risk stratification yields biologic insights into therapeutic opportunities

Garman¹,

Acharya²,

Grade

et al. 2008

Proc. Natl. Acad. Sci. U.S.A.

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“…In gastrointestinal cancer therapy, it is essential to prevent metachronous metastasis. Several adjuvant chemotherapies are helpful in certain disease stages, especially in CRC (Bathe et al, 2004;Andre et al, 2007). Recently, increasing evidence has been accumulated, showing the usefulness of less invasive surgery in the treatment of CRC, such as laparoscopic and endoscopic surgery (Lacy et al, 2002;Weeks et al, 2002;Clinical Outcomes of Surgical Therapy Study Group, 2004;Jayne et al, 2007).…”

Section: Discussionmentioning

confidence: 99%

Abnormal expression of TRIB3 in colorectal cancer: a novel marker for prognosis

et al. 2009

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BACKGROUND: TRIB3 is a human homologue of Drosophila tribbles. Previous studies have shown that TRIB3 controls the cell growth through ubiquitination-dependent degradation of other proteins, whereas its significance in the prognosis of colorectal cancer (CRC) is not yet fully understood. MATERIALS: This study comprised 202 patients who underwent surgery for CRC, as well as 22 cell lines derived from human gastrointestinal cancer. The correlation of gene expression with clinical parameters in patients was assessed. The biological significance was evaluated by knockdown experiments in seven colorectal cancer cell lines. RESULTS: A total of 20 cancer cell lines (90.9%) expressed the TRIB3 gene. The assessment in surgical specimens indicated that the gene expression was significantly higher in the cancerous region than in the marginal non-cancerous region. Patients with high TRIB3 expression were statistically susceptible to a recurrence of the disease, and showed poorer overall survival than those with low expression. The assessment of TRIB3 knockdown in five cell lines showed that small interfering RNA (siRNA) inhibition resulted in a statistically significant reduction in cell growth. CONCLUSION: These data strongly suggest the usefulness of TRIB3 as a marker for predicting the prognosis of CRC patients, showing a basis for the development of effective treatments for CRC.

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“…Moertel et al reported that 12 months of adjuvant chemotherapy with 5-FU plus levamisole yielded excellent outcomes [29]. Thereafter, the Intergroup trial 0089 (INT-0089) and the Groupe Cooperateur Multidisciplinaire en Oncologie trial found no difference in efficacy among 6, 9, and 12 months of 5-FU/LV [13,14]. The ideal duration for adjuvant chemotherapy in patients with colon cancer is 6 months, which is 12 cycles of FOLFOX and 6 of FL.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, no difference was found between 6-and 9-month chemotherapy durations in the GERCOR C96.1 trial [14]. The current recommendation for the duration of adjuvant chemotherapy in patients with colon cancer is 6 months, which is 12 cycles of the FOLFOX regimen and 6 cycles of the 5-FU/leucovorin (FL) regimen.…”

Section: Introductionmentioning

confidence: 99%

Association Between Time (Initiation and Length) and Oncological Outcomes for the Patients with Colon Cancer Treated with Adjuvant Chemotherapy

et al. 2015

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Adjuvant chemotherapy is benefit for high-risk stage II and stage III colon cancer after curative resection. But, the optimal time between surgical and initiation of adjuvant chemotherapy remains unclear. Moreover, no study of efficacy with different lengths of adjuvant chemotherapy has appeared. This study was aimed to identify association between time (initiation and length) and oncological outcomes of adjuvant chemotherapy on the stages II and III colon cancer patients. A total of 406 high-risk stages II and III colon cancer patients were retrospectively enrolled in prospectively collected data. They were categorized into three groups representing chemotherapy initiation time: less than 4 weeks (group 1), 4 to 6 weeks (group 2), and more than 6 weeks (group 3). They were categorized into two groups representing chemotherapy length time : less than 200 days (group 1a) and more than 200 days (group 2a). The 5-year disease-free survival (DFS) rates were 74.97 % in group 1, 76.94 % in group 2, and 63.97 % in group 3 (p>0.05). The 5-year DFS rates were 75.49 % in the group that received adjuvant chemotherapy within 6 weeks and 63.97 % in the group that received adjuvant chemotherapy >6 weeks (p=0.0539). The 5-year DFS rates were 77.21 % in group 1a and 81.82 % in group 2a (p>0.05). Adjuvant chemotherapy should be safely offered within 6 weeks after surgical excision in patients with colon cancer after considering the patient's general physical condition and hematological factors, even if the chemotherapy length is prolonged.

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Phase III Study Comparing a Semimonthly With a Monthly Regimen of Fluorouracil and Leucovorin As Adjuvant Treatment for Stage II and III Colon Cancer Patients: Final Results of GERCOR C96.1

Cited by 135 publications

References 21 publications

RETRACTED: A genomic approach to colon cancer risk stratification yields biologic insights into therapeutic opportunities

RETRACTED: A genomic approach to colon cancer risk stratification yields biologic insights into therapeutic opportunities

Abnormal expression of TRIB3 in colorectal cancer: a novel marker for prognosis

Association Between Time (Initiation and Length) and Oncological Outcomes for the Patients with Colon Cancer Treated with Adjuvant Chemotherapy

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