RTP Mobile Logo

60 yo w/ MSS T4N0 tumor: Would you offer Oncotype DX® assay? If not, what Tx recommend?

Would you offer an Oncotype DX assay for an otherwise healthy 60-year-old patient with a Grade II, MSS T4N0 (0 out of 20 nodes positive) tumor?

If not, what adjuvant systemic therapy would you likely recommend for this patient?

André T et al. Improved overall survival with oxaliplatin, fluorouracil, and leucovorin as adjuvant treatment in stage II or III colon cancer in the MOSAIC trial. J Clin Oncol 2009;27:3109-16. Abstract

Gray RG et al. Validation study of a quantitative multigene reverse transcriptase-polymerase chain reaction assay for assessment of recurrence risk in patients with stage II colon cancer. J Clin Oncol 2011;29(35):4611-9. Abstract

Kerr DJ et al. Biological markers: Tailoring treatment and trials to prognosis. Nat Rev Clin Oncol 2013;10(8):429-30. Abstract

Love N et al. Is adjuvant oxaliplatin (Ox) overutilized in colon cancer (CC)? 408 cases from the practices of 102 oncologists. Gastrointestinal Cancers Symposium 2013;Abstract 479.

O’Connell MJ et al. Validation of the 12-gene colon cancer Recurrence Score result in NSABP C-07 as a predictor of recurrence in stage II and III colon cancer patients treated with 5FU/LV (5FU) and 5FU/LV + oxaliplatin (5FU+Ox). Proc ASCO 2012;Abstract 3512.

Shi Q et al. Comparison of outcomes after fluorouracil-based adjuvant therapy for stages II and III colon cancer between 1978 to 1995 and 1996 to 2007: Evidence of stage migration from the ACCENT database. J Clin Oncol 2013;31(29):3656-63. Abstract

Tournigand C et al. Adjuvant therapy with fluorouracil and oxaliplatin in stage II and elderly patients (between ages 70 and 75 years) with colon cancer: Subgroup analyses of the Multicenter International Study of Oxaliplatin, Fluorouracil, and Leucovorin in the Adjuvant Treatment of Colon Cancer trial. J Clin Oncol 2012;30(27):3353-60. Abstract

Wolmark N. Considerations in the use of adjuvant oxaliplatin for localized colon cancer and the utility of gene signature assays. Gastrointestinal Cancer Update, Issue 2, 2013. Available at http://www.researchtopractice.com/GICU213/norman-wolmark-md/considerations-use-adjuvant-oxaliplatin-localized-colon-cancer-and-utility.