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

Edouard Auclin, Thierry André, Julien Taieb, Maria Banzi, Jean Luc Van Laethem, Josep Tabernero, Tamas Hickish, Aimery de Gramont, Dewi Vernerey

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Abstract

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).

Original languageEnglish
JournalBritish Journal of Cancer
DOIs
Publication statusPublished - Jan 1 2019

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oxaliplatin
Carcinoembryonic Antigen
Colonic Neoplasms
Survival
Disease-Free Survival
Proportional Hazards Models

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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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. / Auclin, Edouard; André, Thierry; Taieb, Julien; Banzi, Maria; Van Laethem, Jean Luc; Tabernero, Josep; Hickish, Tamas; de Gramont, Aimery; Vernerey, Dewi.

In: British Journal of Cancer, 01.01.2019.

Research output: Contribution to journalArticle

Auclin, Edouard ; André, Thierry ; Taieb, Julien ; Banzi, Maria ; Van Laethem, Jean Luc ; Tabernero, Josep ; Hickish, Tamas ; de Gramont, Aimery ; Vernerey, Dewi. / 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. In: British Journal of Cancer. 2019.
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abstract = "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).",
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T1 - Association of post-operative CEA with survival and oxaliplatin benefit in patients with stage II colon cancer

T2 - 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 - 2019/1/1

Y1 - 2019/1/1

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).

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