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These studies suggest that various adjuvant therapies, including S-1, oxaliplatin, and UFT/LV, as well as predictive tools like ColoPrint, can significantly improve survival rates and disease-free survival in stage II cancer patients, particularly for gastric and colon cancers.
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Adjuvant chemotherapy with S-1 has shown significant improvements in survival rates for patients with stage II gastric cancer. A study comparing S-1 treatment to surgery alone found that the 5-year overall survival rate was 71.7% for the S-1 group, compared to 61.1% for the surgery-only group. Additionally, the relapse-free survival rate was higher in the S-1 group at 65.4%, compared to 53.1% in the surgery-only group.
In stage II colon cancer, the expression of the CDX2 biomarker has been identified as a significant prognostic factor. Patients with CDX2-negative tumors had a lower 5-year disease-free survival rate compared to those with CDX2-positive tumors. Specifically, the 5-year disease-free survival was 49% for CDX2-negative patients versus 87% for CDX2-positive patients in one cohort, and 51% versus 80% in another cohort. This suggests that CDX2-negative patients are at higher risk and may benefit more from adjuvant chemotherapy.
The MOSAIC trial demonstrated that adding oxaliplatin to the standard fluorouracil and leucovorin regimen (FOLFOX4) significantly improved 5-year disease-free survival (DFS) and 6-year overall survival (OS) in patients with stage II or III colon cancer. The 5-year DFS rates were 73.3% for the FOLFOX4 group compared to 67.4% for the standard treatment group. However, the improvement in overall survival was more pronounced in stage III patients.
The ColoPrint genomic classifier has been shown to predict recurrence in stage II colorectal cancer patients more accurately than traditional clinical factors. In a pooled analysis, ColoPrint identified 63% of patients as low risk with a 5-year risk of relapse (ROR) of 10%, while high-risk patients had a 5-year ROR of 21%. This tool helps in stratifying patients more effectively for additional treatments.
A study on the efficacy of uracil and tegafur/leucovorin (UFT/LV) for stage II colon cancer with high-risk factors for recurrence found that the 5-year disease-free survival rate was significantly higher in the UFT/LV group (76.3%) compared to the surgery-only group (68.8%). This suggests that adjuvant chemotherapy with UFT/LV can be beneficial for high-risk stage II colon cancer patients.
In stage II and III HER2-positive breast cancer, neoadjuvant chemotherapy combined with HER2-targeted agents has shown promising results. The TRAIN-3 study reported that after three cycles of paclitaxel, trastuzumab, carboplatin, and pertuzumab (PTC-Ptz), 33.6% of hormone receptor-negative (HR-) patients and 15.5% of hormone receptor-positive (HR+) patients achieved a pathologic complete response (pCR). Extending the treatment to six cycles further improved pCR rates.
The survival rates for stage II cancer vary significantly depending on the type of cancer and the treatment regimen. Adjuvant chemotherapy and targeted therapies have shown to improve survival rates in gastric, colon, and breast cancers. Biomarkers like CDX2 and genomic classifiers like ColoPrint are valuable tools for identifying high-risk patients who may benefit from additional treatments. These advancements highlight the importance of personalized treatment strategies in improving outcomes for stage II cancer patients.
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