XELOX vs FOLFOX-4 as first-line therapy for metastatic colorectal cancer: NO16966 updated results
2011

Comparing XELOX and FOLFOX-4 for Colorectal Cancer Treatment

Sample size: 2034 publication 10 minutes Evidence: high

Author Information

Author(s): Cassidy J, Clarke S, Díaz-Rubio E, Scheithauer W, Figer A, Wong R, Koski S, Rittweger K, Gilberg F, Saltz L

Primary Institution: Institute of Cancer Sciences, Beatson Oncology Centre

Hypothesis

Is XELOX non-inferior to FOLFOX-4 as first-line therapy for metastatic colorectal cancer?

Conclusion

XELOX is similar to FOLFOX4 and can be considered a routine first-line treatment option for metastatic colorectal cancer.

Supporting Evidence

  • XELOX showed a median overall survival of 19.8 months.
  • FOLFOX4 showed a median overall survival of 19.5 months.
  • FOLFOX4 was associated with more grade 3/4 neutropenia than XELOX.
  • XELOX was associated with more grade 3 diarrhoea than FOLFOX4.

Takeaway

This study looked at two treatments for cancer and found that one treatment works just as well as the other, so doctors can choose either one for their patients.

Methodology

A randomised, two-arm, non-inferiority, phase III study comparing XELOX and FOLFOX4 with further randomisation to bevacizumab or placebo.

Potential Biases

Potential confounding factors due to crossover to alternate treatments after study completion.

Limitations

The study was not powered for formal testing of non-inferiority for overall survival.

Participant Demographics

{"age":{"median":61,"range":"18-86"},"gender":{"male":61,"female":39}}

Statistical Information

P-Value

0.95

Confidence Interval

97.5% CI 0.85–1.06

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1038/bjc.2011.201

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