Colon Cancer · Medical Oncology
MOSAIC
In resected stage II/III colon cancer, does adding oxaliplatin to fluoropyrimidine improve disease control and survival?
Population
2246 patients with completely resected stage II or III colon cancer
5-year DFS
73.3% vs 67.4%
Absolute improvement 5.9 points; NNT 17
6-year OS
78.5% vs 76.0%
Stage III: 72.9% vs 68.7%
Grade 3 sensory neuropathy
12.5% vs 0.2%
Absolute increase 12.3 points; NNH 8
Absolute Effect
NNT: 17, based on 5-year disease-free survival. The absolute DFS gain was 5.9 percentage points.
NNH: 8, based on grade 3 sensory neuropathy. Oxaliplatin introduced a substantial cumulative neurologic toxicity burden that became central to later duration-de-escalation studies.
Clinical interpretation
MOSAIC established oxaliplatin-containing adjuvant therapy as an important efficacy advance, but its absolute benefit must be weighed against neuropathy. This benefit–harm tension is precisely why treatment duration and patient risk matter.
Primary source
André T, et al. J Clin Oncol. 2009;27:3109–3116.