The IDEA study showed that the type and duration of adjuvant chemotherapy in stage III colon cancer (CC) could be adjusted according to level of risk (Grothey et al., New Engl J Med 2018). One year after the publication of IDEA study, we performed an audit of real-life practices in France.
We conducted an online anonymized nationwide survey from January 30, 2019 to March 31, 2019. An invitation email followed by reminders every 2 weeks was sent to clinicians using the oncology cooperative groups GERCOR, FFCD and GI UNICANCER mailing lists. All of the answers were declarative, individual, and anonymized. Proportions were compared using chi-squared test.
A total of 213 physicians answered the survey: 31% worked in an academic hospital, 27% in a general hospital, 26% in a comprehensive cancer center and 16% in a private clinic. Main responders were gastroenterologists (51%) or medical oncologists (39%). 47% of physicians took care of more than 12 stage III CC patients per year. For low risk stage III CC (T1-T3 and N1), 81% preferred a 3-month duration of treatment, and 74% used capecitabine plus oxaliplatine (CAPOX) as the standard regimen. 66% of CAPOX for 3 months were realized without central venous access device, which was necessary during treatment in less than 25% of cases according to 68% of the responders. Physicians choosing 6-month duration of adjuvant treatment for low risk stage III CC were more often medical oncologists (58% versus 35%, P = 0.009) or working in a general hospital (48% versus 22%, P = 0.001); no significant difference was observed considering years of professional experience or the number of patients treated per year. For high risk stage III CC (T4 and/or N2), 99.5% of responders considered that adjuvant chemotherapy should be prescribed for 6 months, and 94% with FOLFOX.
One year after the publication of the IDEA study, 3 months of adjuvant chemotherapy with CAPOX has been mainly integrated as a new standard of care for low risk stage III CC patients in daily practice whereas 6 months of FOLFOX remains the standard of care of high risk stage III CC.
GERCOR.
Has not received any funding.
B. Rousseau: Research grant / Funding (institution), Travel / Accommodation / Expenses: Bayer; Research grant / Funding (institution), Travel / Accommodation / Expenses: Servier; Research grant / Funding (institution), Travel / Accommodation / Expenses: Novartis; Research grant / Funding (institution), Travel / Accommodation / Expenses: Roche; Research grant / Funding (institution), Travel / Accommodation / Expenses: Gilead; Research grant / Funding (institution), Travel / Accommodation / Expenses: AbbVie. All other authors have declared no conflicts of interest.