TY - JOUR
T1 - Association of post-operative CEA with survival and oxaliplatin benefit in patients with stage II colon cancer: a post hoc analysis of the MOSAIC trial.
AU - Auclin, Edouard
AU - André, Thierry
AU - Taieb, Julien
AU - Banzi, Maria
AU - Van Laethem, Jean Luc
AU - Tabernero, Josep
AU - Hickish, Tamas
AU - de Gramont, Aimery
AU - Vernerey, Dewi
PY - 2019/8/1
Y1 - 2019/8/1
N2 - Background: Adjuvant treatment for stage II colon cancer (CC) can be proposed to patients with high-risk disease. Recently, 2.35 ng/mL carcinoembryonic antigen (CEA) was identified as the best cut-off value. This post hoc analysis of the MOSAIC trial assessed post-operative CEA prognostic value for survival outcomes and predictive value for the addition of oxaliplatin to adjuvant treatment. Methods: Prognostic and predictive values of post-operative CEA in patients with stage II CC were evaluated with Kaplan–Meier survival curves and Cox model with interaction terms. Disease-free survival (DFS) and overall survival (OS) were estimated. Results: Among 899 stage II CC patients, post-operative CEA was available in 867 (96.4%); and 434 (48.65%) had a high-risk stage II disease. The 3-year DFS rate was 88.5% and 78.7% in the ≤ 2.35 ng/mL and > 2.35 ng/mL group, respectively (P = 0.006). Use of oxaliplatin showed survival benefit only in patients with high-risk stage II CC and post-operative CEA > 2.35 ng/ml (interaction term P = 0.09 and 0.03 for DFS and OS). Conclusion: CEA is a strong prognostic factor for DFS and OS in stage II CC. In the MOSAIC trial, only high-risk stage II CC patients with post-operative CEA > 2.35 ng/mL benefited from the addition of oxaliplatin to LV5FU2. Trial registration: NCT00275210 (January 11, 2006).
AB - Background: Adjuvant treatment for stage II colon cancer (CC) can be proposed to patients with high-risk disease. Recently, 2.35 ng/mL carcinoembryonic antigen (CEA) was identified as the best cut-off value. This post hoc analysis of the MOSAIC trial assessed post-operative CEA prognostic value for survival outcomes and predictive value for the addition of oxaliplatin to adjuvant treatment. Methods: Prognostic and predictive values of post-operative CEA in patients with stage II CC were evaluated with Kaplan–Meier survival curves and Cox model with interaction terms. Disease-free survival (DFS) and overall survival (OS) were estimated. Results: Among 899 stage II CC patients, post-operative CEA was available in 867 (96.4%); and 434 (48.65%) had a high-risk stage II disease. The 3-year DFS rate was 88.5% and 78.7% in the ≤ 2.35 ng/mL and > 2.35 ng/mL group, respectively (P = 0.006). Use of oxaliplatin showed survival benefit only in patients with high-risk stage II CC and post-operative CEA > 2.35 ng/ml (interaction term P = 0.09 and 0.03 for DFS and OS). Conclusion: CEA is a strong prognostic factor for DFS and OS in stage II CC. In the MOSAIC trial, only high-risk stage II CC patients with post-operative CEA > 2.35 ng/mL benefited from the addition of oxaliplatin to LV5FU2. Trial registration: NCT00275210 (January 11, 2006).
UR - http://www.scopus.com/inward/record.url?scp=85068769669&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85068769669&partnerID=8YFLogxK
U2 - 10.1038/s41416-019-0521-7
DO - 10.1038/s41416-019-0521-7
M3 - Article
C2 - 31296923
AN - SCOPUS:85068769669
VL - 121
SP - 312
EP - 317
JO - British Journal of Cancer
JF - British Journal of Cancer
SN - 0007-0920
IS - 4
ER -