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


Authors: Cassidy, J.; Clarke, S.; Díaz-Rubio, E.; Scheithauer, W.; Figer, A.; Wong, R.; Koski, S.; Rittweger, K.; Gilberg, F.; Saltz, L.
Article Title: XELOX vs FOLFOX-4 as first-line therapy for metastatic colorectal cancer: NO16966 updated results
Abstract: Background:We report updated overall survival (OS) data from study NO16966, which compared capecitabine plus oxaliplatin (XELOX) vs 5-fluorouracil/folinic acid plus oxaliplatin (FOLFOX4) as first-line therapy in metastatic colorectal cancer.Methods:NO16966 was a randomised, two-arm, non-inferiority, phase III comparison of XELOX vs FOLFOX4, which was subsequently amended to a 2 × 2 factorial design with further randomisation to bevacizumab or placebo. A planned follow-up exploratory analysis of OS was performed.Results:The intent-to-treat (ITT) population comprised 2034 patients (two-arm portion, n634; 2 × 2 factorial portion, n1400). For the whole NO16966 study population, median OS was 19.8 months in the pooled XELOX/XELOX-placebo/XELOX-bevacizumab arms vs 19.5 months in the pooled FOLFOX4/FOLFOX4-placebo/FOLFOX4-bevacizumab arms (hazard ratio 0.95 (97.5% CI 0.85-1.06)). In the pooled XELOX/XELOX-placebo arms, median OS was 19.0 vs 18.9 months in the pooled FOLFOX4/FOLFOX4-placebo arms (hazard ratio 0.95 (97.5% CI 0.83-1.09)). FOLFOX4 was associated with more grade 3/4 neutropenia/granulocytopenia and febrile neutropenia than XELOX, and XELOX with more grade 3 diarrhoea and grade 3 hand-foot syndrome than FOLFOX4.Conclusion: Updated survival data from study NO16966 show that XELOX is similar to FOLFOX4, confirming the primary analysis of progression-free survival. XELOX can be considered as a routine first-line treatment option for patients with metastatic colorectal cancer. © 2011 Cancer Research UK All rights reserved.
Keywords: adult; controlled study; aged; major clinical study; overall survival; bevacizumab; fluorouracil; placebo; diarrhea; capecitabine; comparative study; follow up; colorectal cancer; progression free survival; febrile neutropenia; folinic acid; hazard ratio; randomization; oxaliplatin; hand foot syndrome; granulocytopenia; 5-fluorouracil/folinic acid; factorial design
Journal Title: British Journal of Cancer
Volume: 105
Issue: 1
ISSN: 0007-0920
Publisher: Nature Publishing Group  
Date Published: 2011-06-28
Start Page: 58
End Page: 64
Language: English
DOI: 10.1038/bjc.2011.201
PROVIDER: scopus
PMCID: PMC3137415
PUBMED: 21673685
DOI/URL:
Notes: --- - "Export Date: 17 August 2011" - "CODEN: BJCAA" - "Source: Scopus"
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  1. Leonard B Saltz
    790 Saltz