Planned Safety Analysis of the ACTS-CC 02 Trial: A Randomized Phase III Trial of S-1 With Oxaliplatin Versus Tegafur and Uracil With Leucovorin as Adjuvant Chemotherapy for High-Risk Stage III Colon Cancer

Clin Colorectal Cancer. 2018 Jun;17(2):e153-e161. doi: 10.1016/j.clcc.2017.10.015. Epub 2017 Nov 1.

Abstract

Background: This trial was designed to verify the superiority of 6 months of postoperative adjuvant chemotherapy with SOX (S-1 with oxaliplatin) with UFT (tegafur and uracil) with LV (leucovorin) in terms of disease-free survival in patients with high-risk stage III colon cancer. We report the results of a planned safety analysis.

Patients and methods: Patients who underwent curative resection for high-risk stage III colon cancer (any T, N2, or positive nodes around the origin of the feeding arteries) were randomly assigned to receive either UFT/LV (300-600 mg/d UFT with 75 mg/d LV on days 1-28, every 35 days, for 5 cycles) or SOX (100 mg/m2 of oxaliplatin on day 1 with 80-120 mg/d S-1 on days 1-14, every 21 days, for 8 cycles). Treatment status and safety were evaluated.

Results: A total of 966 patients were enrolled, and 932 patients were included in safety analyses. The planned 6-month protocol treatment was received by 76.9% of the patients in the UFT/LV group and 65.8% of those in the SOX group. The overall incidence of any Grade adverse events (AEs) were 91.3% in the UFT/LV group and 98.7% in the SOX group, and those of Grade ≥ 3 AEs were 16.1% and 36.1%, respectively. As for Grade ≥ 3 AEs, leukopenia, neutropenia, thrombocytopenia, and sensory neuropathy were more common in the SOX group. The incidence of Grade ≥ 3 sensory peripheral neuropathy was 4.6% in the SOX group.

Conclusion: The completion rate of adjuvant SOX and its incidence of AEs were acceptable in patients with colon cancer.

Keywords: Adverse events; L-OHP; Oral fluorouracil; Sensory peripheral neuropathy; Tegafur/gimeracil/oteracil.

Publication types

  • Clinical Trial, Phase III
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Chemotherapy, Adjuvant / adverse effects*
  • Chemotherapy, Adjuvant / methods*
  • Colorectal Neoplasms / drug therapy*
  • Colorectal Neoplasms / mortality
  • Disease-Free Survival
  • Drug Combinations
  • Female
  • Humans
  • Leucovorin / administration & dosage
  • Leucovorin / adverse effects
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Oxaliplatin / administration & dosage
  • Oxaliplatin / adverse effects
  • Oxonic Acid / administration & dosage
  • Oxonic Acid / adverse effects
  • Tegafur / administration & dosage
  • Tegafur / adverse effects
  • Uracil / administration & dosage
  • Uracil / adverse effects

Substances

  • Drug Combinations
  • Oxaliplatin
  • S 1 (combination)
  • Tegafur
  • Uracil
  • Oxonic Acid
  • Leucovorin