{"entity":{"id":"idea-collaboration","kind":"trial","name":"IDEA collaboration","aka":["International Duration Evaluation of Adjuvant chemotherapy","IDEA"],"tldr":"Six national trials pooled their results to ask whether three months of chemotherapy after bowel cancer surgery is as good as six. For low-risk disease it is, and it causes far less nerve damage.","summary":"IDEA was a prospective, preplanned pooled analysis of six concurrent phase 3 non-inferiority trials in resected stage III colon cancer. Across 12,834 patients and 3,263 events the non-inferiority of three months was not confirmed overall (hazard ratio 1.07, 95% CI 1.00 to 1.15 against a margin of 1.12), but it held for CAPOX (0.95, 0.85 to 1.06) and not for FOLFOX (1.16, 1.06 to 1.26). In the exploratory low-risk group (T1 to T3 and N1) three-year disease-free survival was 83.1 against 83.3 percent (hazard ratio 1.01); in T4 or N2 disease six months was better. Grade 2 or worse neuropathy roughly halves with the shorter course. The result is the two-tier recommendation in every guideline: three months of CAPOX for low-risk stage III, six months of FOLFOX or CAPOX for T4 or N2 disease.","status":"mixed","asOf":"2026-09-24","links":[{"label":"IDEA: duration of adjuvant chemotherapy for stage III colon cancer (New England Journal of Medicine 2018)","url":"https://doi.org/10.1056/NEJMoa1713709"}],"tags":[],"related":[],"cancers":["colorectal","colon-cancer"],"sections":[],"technologies":["cytotoxic-chemotherapy","platinum"],"targets":[],"drugs":["folfox","capox","oxaliplatin","capecitabine","fluorouracil"],"companies":[],"institutions":[],"pathways":[],"terms":["neoadjuvant-adjuvant","de-escalation"],"trials":["scot","tosca","mosaic"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"phase":"3","setting":"Stage III colon cancer after resection: three months of adjuvant FOLFOX or CAPOX against six months, pooled across six trials","sponsor":"Six concurrent trial groups (SCOT, TOSCA, IDEA France, CALGB/SWOG 80702, ACHIEVE, HORG)","result":"Three months non-inferior to six for CAPOX and for low-risk (T1-3 N1) disease; six months better for T4 or N2.","yearReported":2018,"enrolled":12834,"enrolledBasis":"analysed","enrolledNote":"A prospective pooled analysis of six randomised trials rather than a single registration; 12,834 patients were analysed after 3,263 events.","outcomes":[{"endpoint":"Disease-free survival at 3 years (overall)","primary":true,"unit":"hazard ratio","arms":[{"name":"3 months","value":1.07,"note":"non-inferiority not confirmed"},{"name":"6 months","value":1}],"hr":1.07,"ci":[1,1.15],"source":"https://doi.org/10.1056/NEJMoa1713709"},{"endpoint":"Disease-free survival at 3 years (T1-3 N1)","unit":"percent","arms":[{"name":"3 months","value":83.1},{"name":"6 months","value":83.3}],"hr":1.01,"ci":[0.9,1.12],"source":"https://doi.org/10.1056/NEJMoa1713709"}]},"route":"/trials/idea-collaboration/","neighbours":{"cancer":[{"id":"colon-cancer","kind":"cancer","name":"Colon cancer (adenocarcinoma of the colon)","route":"/cancers/colon-cancer/"},{"id":"colorectal","kind":"cancer","name":"Colorectal cancer","route":"/cancers/colorectal/"}],"technology":[{"id":"cytotoxic-chemotherapy","kind":"technology","name":"Cytotoxic chemotherapy","route":"/technologies/cytotoxic-chemotherapy/"},{"id":"platinum","kind":"technology","name":"Platinum agents","route":"/technologies/platinum/"}],"drug":[{"id":"capecitabine","kind":"drug","name":"Capecitabine","route":"/drugs/capecitabine/"},{"id":"capox","kind":"drug","name":"CAPOX (capecitabine, oxaliplatin)","route":"/drugs/capox/"},{"id":"fluorouracil","kind":"drug","name":"Fluorouracil (5-FU)","route":"/drugs/fluorouracil/"},{"id":"folfox","kind":"drug","name":"FOLFOX (5-FU, leucovorin, oxaliplatin)","route":"/drugs/folfox/"},{"id":"oxaliplatin","kind":"drug","name":"Oxaliplatin","route":"/drugs/oxaliplatin/"}],"term":[{"id":"de-escalation","kind":"term","name":"De-escalation, escalation and response-adapted therapy","route":"/terms/de-escalation/"},{"id":"neoadjuvant-adjuvant","kind":"term","name":"Neoadjuvant / adjuvant / perioperative","route":"/terms/neoadjuvant-adjuvant/"}],"trial":[{"id":"atomic","kind":"trial","name":"ATOMIC (Alliance A021502)","route":"/trials/atomic/"},{"id":"challenge","kind":"trial","name":"CHALLENGE (CCTG CO.21)","route":"/trials/challenge/"},{"id":"mosaic","kind":"trial","name":"MOSAIC","route":"/trials/mosaic/"},{"id":"quasar","kind":"trial","name":"QUASAR","route":"/trials/quasar/"},{"id":"scot","kind":"trial","name":"SCOT","route":"/trials/scot/"},{"id":"tosca","kind":"trial","name":"TOSCA","route":"/trials/tosca/"}]}}