Patients’ preferences for 3 months vs 6 months of adjuvant chemotherapy for colon cancer

Blinman, P. et al. (2021) Patients’ preferences for 3 months vs 6 months of adjuvant chemotherapy for colon cancer. JNCI Cancer Spectrum, 5(1), pkaa107. (doi: 10.1093/jncics/pkaa107) (PMID:34159294) (PMCID:PMC7883552)

Abstract

Background: SCOT was an international, randomized phase 3 trial of 3 months vs 6 months of adjuvant chemotherapy with oxaliplatin and a fluoropyrimidine in patients with colorectal cancer. We sought patients’ preferences for 3 months vs 6 months of adjuvant chemotherapy in the SCOT trial. Methods: SCOT participants from Australia and New Zealand completed a validated questionnaire (at 3 and 18 months) to elicit the minimum survival benefits judged necessary to make an extra 3 months of adjuvant chemotherapy worthwhile, based on their experience. Standardized hypothetical scenarios used the following baseline survivals (with 3 months of chemotherapy): life expectancies (LE) of 5 years and 15 years and 5-year survival rates (5YS) of 65% and 85%. Results: Of the 160 participants, 82 were assigned 3 months adjuvant chemotherapy, and 78 were assigned 6 months. Adjuvant chemotherapy was FOLFOX in 121 (75.6%) and XELOX in 39 (24.4%). Preferences varied substantially and did not differ according to treatment group. The median survival benefits judged necessary to make the extra 3 months of chemotherapy worthwhile were an extra 3 years beyond a LE of 5 years; 3 years beyond a LE of 15 years; 15% beyond a 5YS of 65%; and 5% beyond a 5YS of 85%. Preferences were similar at 3 months and 18 months. Preferences were not predicted by participants’ baseline characteristics. Conclusion: Preferences varied substantially, and the benefits many required to warrant an extra 3 months of adjuvant chemotherapy were larger than the benefits of an extra 3 months of chemotherapy calculated in the International Duration Evaluation of Adjuvant Chemotherapy (IDEA) meta-analysis.

• Item Type: Articles
• Additional Information: The SCOT trial was supported in Australia by 2 Cancer Australia Priority-driven Collaborative Cancer Research Scheme grants (57134 & 1086013). The Australasian Gastro-Intestinal Trials Group was the study sponsor, and the NHMRC Clinical Trial Centres was the regional coordinating center. The NHMRC Clinical Trials Centre is supported by an Australian NHMRC Program Grant (APP1037786).
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Harkin, Mrs Andrea
• Authors: Blinman, P., Martin, A., Jefford, M., Goldstein, D., Boadle, D., Morris, M., Tebbutt, N., Aiken, C., Harkin, A., Segelov, E., Haydon, A., Iveson, T., and Stockler, M. R.
• College/School: College of Medical Veterinary and Life Sciences > School of Cancer Sciences
• Journal Name: JNCI Cancer Spectrum
• Publisher: Oxford University Press
• ISSN: 2515-5091
• ISSN (Online): 475-4029
• Published Online: 28 November 2020
• Copyright Holders: Copyright © The Author(s) 2020
• First Published: First published in JNCI Cancer Spectrum 5(1): pkaa107
• Publisher Policy: Reproduced under a Creative Commons License