Changes in Prescribing Patterns in Stage III Colon Cancer

Area of Science:

• Oncology
• Clinical Trials
• Cancer Treatment

Background:

• Standard adjuvant chemotherapy for resected stage III colon cancer is 6 months.
• The IDEA collaboration investigated if 3 months of chemotherapy was noninferior to 6 months.
• Subgroup analyses suggested noninferiority with risk-stratification.

Purpose of the Study:

• To assess the impact of IDEA collaboration findings on clinical practice.
• To analyze trends in adjuvant chemotherapy regimen and duration from 2016-2021.
• To evaluate prescribing patterns before and after IDEA abstract presentation and manuscript publication.

Main Methods:

• Retrospective analysis of 399 patients with stage III colon cancer.
• Evaluation of chemotherapy prescribing practices (regimen and duration).
• Comparison of treatment patterns before and after key IDEA collaboration publications.

Main Results:

• A significant increase in 3-month adjuvant chemotherapy use was observed post-IDEA abstract presentation (P<.001).
• CAPOX (capecitabine/oxaliplatin) use increased from 14% to 48% post-presentation (P<.001).
• 3-month CAPOX use increased significantly over time, regardless of cancer risk (aOR, 1.28; P<.001).

Conclusions:

• Despite not meeting its primary endpoint, IDEA findings influenced prescribing.
• Clinical practice shifted towards shorter (3-month) adjuvant chemotherapy durations.
• CAPOX emerged as a favored regimen for shorter-duration treatment in stage III colon cancer.