Efficacy and Safety of Capecitabine and Oxaliplatin (CapOX) as an Adjuvant Therapy in Japanese for Stage II/III Colon Cancer in a Group at High Risk of Recurrence in Retrospective Study

Abstract

A number of large-scale clinical trials have demonstrated that using a combination of oxaliplatin and fluoropyrimidines as an adjuvant chemotherapy for stage II/III colon cancer improved the prognosis. However, there has only been experience in Japanese patients with using CapOX therapy, in which capecitabine and oxaliplatin are used in combination. Therefore, our objective was to evaluate the efficacy and safety of CapOX in Japanese patients as an adjuvant chemotherapy for colon cancer in a single institute retrospective study. The efficacy and safety of CapOX as an adjuvant chemotherapy for patients with stage III colon cancer and stage II patients who had a signature for high risk of recurrence were evaluated in patients who had undergone surgery at our institution between December 1, 2009 and March 31, 2013. Forty-one patients received CapOX therapy during the study period: 23 men and 18 women with median age of 68.0 years (35-79 years). Performance status was 0 for 33 patients, and PS 1 for eight patients. The clinical stages were stage II in 14 patients, stage IIIA in 15 patients, and stage IIIB in 12 patients. The median number of CapOX cycles was eight (two to eight courses). The treatment completion rate was 82.9%. Five-year DFS rates were 63.8%. Five-year OS rates were 71.0%. In terms of adverse events, the serious adverse events of grade 3 or higher seen among all patients were neutropenia in four patients, thrombocytopenia in one patient, and peripheral sensory neuropathy in seven patients. However, hand-foot syndrome, which is characteristic of capecitabine, was not observed. Efficacy and tolerability of CapOX in Japanese patients as an adjuvant chemotherapy after colon cancer surgery was demonstrated.

Figure 1

(A) Disease-free survival (DFS); (B) overall survival (OS) (N = 41).