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Patients' Preferences for 3 Months vs 6 Months of Adjuvant Chemotherapy for Colon Cancer

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journal contribution
posted on 28.07.2021, 03:44 by Prunella Blinman, Andrew Martin, Michael Jefford, David Goldstein, David Boadle, Michelle Morris, Niall Tebbutt, Christine Aiken, Andrea Harkin, Eva Segelov, Andrew Haydon, Tim Iveson, Martin R Stockler
Abstract Background SCOT was an international, randomized phase 3 trial of 3 months vs 6 months of adjuvant chemotherapy with oxaliplatin and a fluoropyrimidine in patients with colorectal cancer. We sought patients’ preferences for 3 months vs 6 months of adjuvant chemotherapy in the SCOT trial. Methods SCOT participants from Australia and New Zealand completed a validated questionnaire (at 3 and 18 months) to elicit the minimum survival benefits judged necessary to make an extra 3 months of adjuvant chemotherapy worthwhile, based on their experience. Standardized hypothetical scenarios used the following baseline survivals (with 3 months of chemotherapy): life expectancies (LE) of 5 years and 15 years and 5-year survival rates (5YS) of 65% and 85%. Results Of the 160 participants, 82 were assigned 3 months adjuvant chemotherapy, and 78 were assigned 6 months. Adjuvant chemotherapy was FOLFOX in 121 (75.6%) and XELOX in 39 (24.4%). Preferences varied substantially and did not differ according to treatment group. The median survival benefits judged necessary to make the extra 3 months of chemotherapy worthwhile were an extra 3 years beyond a LE of 5 years; 3 years beyond a LE of 15 years; 15% beyond a 5YS of 65%; and 5% beyond a 5YS of 85%. Preferences were similar at 3 months and 18 months. Preferences were not predicted by participants’ baseline characteristics. Conclusion Preferences varied substantially, and the benefits many required to warrant an extra 3 months of adjuvant chemotherapy were larger than the benefits of an extra 3 months of chemotherapy calculated in the International Duration Evaluation of Adjuvant Chemotherapy (IDEA) meta-analysis.


The SCOT trial was supported in Australia by 2 Cancer Australia Priority-driven Collaborative Cancer Research Scheme grants (57134 & 1086013). The Australasian Gastro-Intestinal Trials Group was the study sponsor, and the NHMRC Clinical Trial Centres was the regional coordinating center. The NHMRC Clinical Trials Centre is supported by an Australian NHMRC Program Grant (APP1037786).


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