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Three versus 6 months of adjuvant oxaliplatin-fluoropyrimidine chemotherapy for colorectal cancer: final results of SCOT-an international, randomized, phase III, noninferiority trial

Title: Three versus 6 months of adjuvant oxaliplatin-fluoropyrimidine chemotherapy for colorectal cancer: final results of SCOT-an international, randomized, phase III, noninferiority trial
Authors: Iveson, T.; Saunders, M. P.; Kelly, C.; Kerr, R. S.; Cassidy, J.; Hollander, N. H.; Tabernero, J.; Haydon, A.; Glimelius, B.; Harkin, A.; Allan, K.; McQueen, J.; Pearson, S.; Boyd, K. A.; Briggs, A. H.; Waterston, A.; Medley, L.; Ellis, R.; Dhadda, A. S.; Harrison, M.; Falk, S.; Rees, C.; Olesen, R. K.; Propper, D.; Bridgewater, J.; Azzabi, A.; Cunningham, D.; Hickish, T.; Gollins, S.; Wasan, H. S.; Church, D.; Domingo, E.
Contributors: The Christie NHS Foundation Trust, Manchester, United Kingdom.
Publication Year: 2026
Collection: The Christie School of Oncology: Christie Research Publications Repository
Description: Adjuvant chemotherapy for colorectal cancer (CRC) with oxaliplatin and fluoropyrimidine was traditionally given for 6 months but is associated with cumulative peripheral neuropathy. The SCOT study (ISRCTN59757862) was an international, randomized, phase III, noninferiority trial investigating treatment reduction from 6 to 3 months. It originally reported noninferior disease-free survival with reduced toxicity and improved quality of life for 3 months of treatment in 6,088 patients. Here, we report overall survival (OS) with 38 months of additional follow-up. Patients with high-risk stage II and stage III CRC were assigned (1:1) to receive 3 or 6 months of either capecitabine and oxaliplatin (CAPOX) or infusional fluorouracil, leucovorin, and oxaliplatin (FOLFOX; bolus and infused fluorouracil with oxaliplatin) that were selected before random assignment. With a median of 113 months follow-up and 1,255 OS events, 5-year OS for 3 versus 6 months of treatment was 82.4% in both groups (hazard ratio, 0.96; 95% CI, 0.8 to 1.07), proving noninferiority of 3 months of treatment. Noninferiority of 3 months of treatment for OS was also shown in 1,087 patients with rectal cancer. The duration effect is regimen-dependent with noninferiority shown for CAPOX but not for FOLFOX. In summary, SCOT has shown noninferiority for OS with 3 months of adjuvant chemotherapy treatment, which should be recommended for most patients.
Document Type: article in journal/newspaper
File Description: application/pdf
Language: English
ISSN: 41512219
Relation: https://dx.doi.org/10.1200/jco-25-00621; https://christie.openrepository.com/handle/10541/628288; Journal of Clinical Oncology
DOI: 10.1200/jco-25-00621
Availability: https://doi.org/10.1200/jco-25-00621; https://christie.openrepository.com/handle/10541/628288
Accession Number: edsbas.5904A7C4
Database: BASE