Phase II study of capecitabine plus oxaliplatin (CapOX) as adjuvant chemotherapy for locally advanced rectal cancer (CORONA II)

• Published in: International journal of clinical oncology Vol. 25; no. 1; pp. 118 - 125
• Main Authors: Hattori, Norifumi, Nakayama, Goro, Uehara, Keisuke, Aiba, Toshisada, Ishigure, Kiyoshi, Sakamoto, Eiji, Tojima, Yuichiro, Kanda, Mitsuro, Kobayashi, Daisuke, Tanaka, Chie, Yamada, Suguru, Koike, Masahiko, Fujiwara, Michitaka, Nagino, Masato, Kodera, Yasuhiro
• Format: Journal Article
• Language: English
• Published: Singapore Springer Singapore 01.01.2020; Springer Nature B.V
• Subjects: Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Cancer; Cancer Research; Cancer therapies; Capecitabine - administration & dosage; Chemotherapy; Chemotherapy, Adjuvant; Colorectal cancer; Disease-Free Survival; Female; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Neoplasm Recurrence, Local - pathology; Oncology; Original; Original Article; Oxaliplatin; Oxaliplatin - administration & dosage; Patients; Rectal Neoplasms - drug therapy; Rectal Neoplasms - mortality; Rectal Neoplasms - pathology; Rectal Neoplasms - surgery; Rectum; Surgical Oncology; Survival; Treatment Outcome
• ISSN: 1341-9625; 1437-7772
• DOI: 10.1007/s10147-019-01546-3

Objective This multicenter, single-arm phase II study (UMIN000008429) aimed to evaluate the efficacy and safety of capecitabine plus oxaliplatin (CapOX) as postoperative adjuvant chemotherapy for patients with locally advanced rectal cancer. Methods Patients with resectable clinical Stage II or III rectal cancer were enrolled to receive eight cycles of CapOX therapy (130 mg/m 2 oxaliplatin on day 1 and 2000 mg/m 2 oral capecitabine on days 1–14, every 3 weeks) after curative surgical resection. The primary endpoint was 3-year relapse-free survival (RFS) rate, and secondary endpoints were 3-year overall survival (OS) rate, treatment compliance, and safety. Results A total of 40 patients (Stage II, 21; Stage III, 19) were enrolled between September 2012 and November 2015 from seven institutions. Thirty-nine patients (97%) received R0 resection, and 32 patients (84%) received postoperative CapOX therapy. The completion rate of all eight cycles of CapOX therapy was 66%. Relative dose intensities were 87% for oxaliplatin and 84% for capecitabine. At a median follow-up period of 46 months, disease recurrence was observed in nine patients, including three with local recurrence. Three-year RFS and OS rates were 75% (95% CI 57–86%) and 96% (95% CI 80–99%), respectively. Frequencies of Grade ≥ 3 hematological and non-hematologic adverse events were 19% and 38%, respectively. Conclusion CapOX therapy is feasible as adjuvant chemotherapy for locally advanced rectal cancer.