Loading
The trial that put oxaliplatin into chemotherapy after bowel cancer surgery. It cut recurrences by a fifth and, in stage III disease, lengthened life.
MOSAIC randomised 2,246 patients who had undergone curative resection for stage II or III colon cancer to six months of fluorouracil and leucovorin with or without oxaliplatin. Disease-free survival at three years was 78.2 against 72.9 percent (hazard ratio 0.77, p=0.002). At six years overall survival was 78.5 against 76.0 percent (hazard ratio 0.84, p=0.046); the gain was confined to stage III disease (72.9 against 68.7 percent, hazard ratio 0.80, p=0.023) with no difference in stage II. Grade 3 sensory neuropathy affected 12.4 percent during treatment and 1.1 percent at one year, and this cumulative neurotoxicity is what the IDEA duration question later tried to avoid. MOSAIC is the reason adjuvant FOLFOX or CAPOX is offered for stage III colon cancer and the reason stage II disease is treated only when risk factors are present.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
2,246 enrolled.
| Endpoint | Arm | n | Value | HR (95% CI) | p | Source |
|---|---|---|---|---|---|---|
| Disease-free survival at 3 yearsprimary | FOLFOX4 | 1,123 | 78.2 percent | 0.77 | 0.002 | link |
| Fluorouracil and leucovorin | 1,123 | 72.9 percent | ||||
| Overall survival at 6 years (stage III) | FOLFOX4 | - | 72.9 percent | 0.8 | 0.023 | link |
| Fluorouracil and leucovorin | - | 68.7 percent |
Shares IDEA collaboration, Neoadjuvant / adjuvant / perioperative, Oxaliplatin, FOLFOX (5-FU, leucovorin, oxaliplatin).
Shares IDEA collaboration, Leucovorin (folinic acid), Neoadjuvant / adjuvant / perioperative, Fluorouracil (5-FU).
Shares Leucovorin (folinic acid), Neoadjuvant / adjuvant / perioperative, Oxaliplatin, FOLFOX (5-FU, leucovorin, oxaliplatin).
Shares IDEA collaboration, Neoadjuvant / adjuvant / perioperative, Oxaliplatin, FOLFOX (5-FU, leucovorin, oxaliplatin).
Shares Leucovorin (folinic acid), FOLFOX (5-FU, leucovorin, oxaliplatin), Fluorouracil (5-FU), Platinum agents.
Shares Leucovorin (folinic acid), FOLFOX (5-FU, leucovorin, oxaliplatin), Fluorouracil (5-FU), Platinum agents.
Shares Leucovorin (folinic acid), FOLFOX (5-FU, leucovorin, oxaliplatin), Fluorouracil (5-FU), Platinum agents.
Shares Leucovorin (folinic acid), Oxaliplatin, FOLFOX (5-FU, leucovorin, oxaliplatin), Fluorouracil (5-FU).