Would you recommend 3 or 6 months adjuvant chemo for low risk Stage III sigmoid cancer (T3/N1), but with positive LVI and PNI?
Would presence of features considered high risk in stage II sway your interpretation of the IDEA trial?
Answer from: Medical Oncologist at Academic Institution
I would recommend 3 months of CAPOX in this case. For a patient with stage III colon cancer, the presence of LVI and PNI should not influence the treatment plan.
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Answer from: Medical Oncologist at Academic Institution
I agree with @Nishin Bhadkamkar that LVI and PNI are not relevant variables in management of patients with stage III colon cancer. While IDEA collaboration did not meet its prespecified non-inferiority margin of 1.12, sub-group analysis showed that in lower risk patients, e.g. T3N1, 3 months of...
Answer from: Medical Oncologist at Academic Institution
I agree overall with my colleagues from MD Anderson and USC, but would be more emphatic that 3 months of Cape-OX is sufficient. LVI and PNI differentiation are inconsistent pathologic "markers" which generally are not of consistent significance in multi-variate analyses across trials. We should reca...