The early impact of the IDEA collaboration results: how the results changed prescribing practice

Iveson, T., Hanna, C. , Iveson, P., Zhang, S., Levasseur, A. and Meyerhardt, J. (2021) The early impact of the IDEA collaboration results: how the results changed prescribing practice. JNCI Cancer Spectrum, 5(4), pkab043. (doi: 10.1093/jncics/pkab043) (PMID:34350375) (PMCID:PMC8328095)

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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.

Item Type:Articles
Glasgow Author(s) Enlighten ID:Hanna, Catherine
Creator Roles:
Hanna, C.Formal analysis, Writing – original draft, Writing – review and editing
Authors: Iveson, T., Hanna, C., Iveson, P., Zhang, S., Levasseur, A., and Meyerhardt, J.
College/School:College of Medical Veterinary and Life Sciences > School of Cancer Sciences
Journal Name:JNCI Cancer Spectrum
Publisher:Oxford University Press
ISSN (Online):1475-4029
Published Online:15 June 2021
Copyright Holders:Copyright © 2021 The Authors
First Published:First published in JNCI Cancer Spectrum 5(4): pkab043
Publisher Policy:Reproduced under a Creative Commons License

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