Colon cancer - historical

The purpose of this page is to provide references to regimens that are obsolete, outdated, or of historical interest only. Is there a regimen missing from this list? See the main colon cancer page for current regimens.

6 regimens on this page 10 variants on this page

Adjuvant therapy

BCG vaccine monotherapy

Regimen

Study	Dates of enrollment	Evidence	Comparator	Comparative Efficacy
Mavligit et al. 1976	1973-1975	Phase 3 (C)	5-FU & BCG	Not reported

Immunotherapy

• BCG vaccine

References

1. Mavligit GM, Gutterman JU, Burgess MA, Khankhanian N, Seibert GB, Speer JF, Jubert AV, Martin RC, McBride CM, Copeland EM, Gehan EA, Hersh EM. Prolongation of postoperative disease-free interval and survival in human colorectal cancer by BCG or BCG plus 5-fluorouracil. Lancet. 1976 Apr 24;1(7965):871-6. link to original article PubMed
2. NSABP C-01: Wolmark N, Fisher B, Rockette H, Redmond C, Wickerham DL, Fisher ER, Jones J, Glass A, Lerner H, Lawrence W, Prager D, Wexler M, Evans J, Cruz A, Dimitrov N, Jochimsen P; NSABP. Postoperative adjuvant chemotherapy or BCG for colon cancer: results from NSABP protocol C-01. J Natl Cancer Inst. 1988 Mar 2;80(1):30-6. link to original article PubMed
   1. Update: Smith RE, Colangelo L, Wieand HS, Begovic M, Wolmark N. Randomized trial of adjuvant therapy in colon carcinoma: 10-year results of NSABP protocol C-01. J Natl Cancer Inst. 2004 Aug 4;96(15):1128-32. link to original article PubMed
   2. Pooled update: Wilkinson NW, Yothers G, Lopa S, Costantino JP, Petrelli NJ, Wolmark N. Long-term survival results of surgery alone versus surgery plus 5-fluorouracil and leucovorin for stage II and stage III colon cancer: pooled analysis of NSABP C-01 through C-05: a baseline from which to compare modern adjuvant trials. Ann Surg Oncol. 2010 Apr;17(4):959-66. link to original article link to PMC article PubMed

Edrecolomab monotherapy

Regimen

Study	Dates of enrollment	Evidence	Comparator	Comparative Efficacy
Riethmüller et al. 1994	1985-1990	Phase 3 (E-esc)	Observation	Seems to have superior OS
Punt et al. 2002 (Study 157-002)	1995-1999	Phase 3 (E-switch-ooc)	1. FULV	Seems to have inferior OS
			2. FULV & Edrecolomab	Not reported
Niedzwiecki et al. 2011 (CALGB 9581)	1997-2002	Phase 3 (E-esc)	Observation	Did not meet primary endpoint of OS

Note: this was the first monoclonal antibody approved (in Germany) for the therapeutic treatment of cancer; it was never FDA approved and was subsequently removed from the German market.

Preceding treatment

• Surgery

Targeted therapy

• Edrecolomab (Panorex) as follows:
  • Cycle 1: 500 mg IV over 120 minutes once on day 1
  • Cycles 2 to 5: 100 mg IV once on day 1

28-day cycle for 5 cycles

References

1. Riethmüller G, Schneider-Gädicke E, Schlimok G, Schmiegel W, Raab R, Höffken K, Gruber R, Pichlmaier H, Hirche H, Pichlmayr R, Buggisch P, Witte J; German Cancer Aid 17-1A Study Group. Randomised trial of monoclonal antibody for adjuvant therapy of resected Dukes' C colorectal carcinoma. Lancet. 1994 May 14;343(8907):1177-83. link to original article PubMed
2. Study 157-002: Punt CJ, Nagy A, Douillard JY, Figer A, Skovsgaard T, Monson J, Barone C, Fountzilas G, Riess H, Moylan E, Jones D, Dethling J, Colman J, Coward L, MacGregor S. Edrecolomab alone or in combination with fluorouracil and folinic acid in the adjuvant treatment of stage III colon cancer: a randomised study. Lancet. 2002 Aug 31;360(9334):671-7. link to original article PubMed
3. CALGB 9581: Niedzwiecki D, Bertagnolli MM, Warren RS, Compton CC, Kemeny NE, Benson AB 3rd, Eckhardt SG, Alberts S, Porjosh GN, Kerr DJ, Fields A, Rougier P, Pipas JM, Schwartz JH, Atkins J, O'Rourke M, Perry MC, Goldberg RM, Mayer RJ, Colacchio TA. Documenting the natural history of patients with resected stage II adenocarcinoma of the colon after random assignment to adjuvant treatment with edrecolomab or observation: results from CALGB 9581. J Clin Oncol. 2011 Aug 10;29(23):3146-52. Epub 2011 Jul 11. link to original article link to PMC article contains dosing details in manuscript PubMed NCT00002968

Fluorouracil monotherapy

Regimen variant #1, 6 months

Study	Dates of enrollment	Evidence	Comparator	Comparative Efficacy
Li & Ross 1976	1965-1970	Phase 3 (E-esc)	Observation	Superior DFS
De Placido et al. 2005 (IGCS-COL)	1991-1998	Phase 3 (C)	1. FULV 2. 5-FU & LEV 3. FULV & LEV	Did not meet co-primary endpoints of DFS/OS

Preceding treatment

• Surgery

Chemotherapy

• Fluorouracil (5-FU) as follows:
  • Cycle 1: 450 mg/m² IV bolus once per day on days 1 to 5
  • Cycles 2 to 23: 450 mg/m² IV bolus once on day 1

28-day course, then 7-day cycle for 22 cycles (6 months total)

Regimen variant #2, 12 months

Study	Dates of enrollment	Evidence	Comparator	Comparative Efficacy
Schippinger et al. 2005 (ABCSG Study 90)	1991-1999	Phase 3 (C)	1. 5-FU & Levamisole 2. 5-FU, IFN alfa, Levamisole	Superior OS (primary endpoint)
			3. 5-FU & IFN alfa	Did not meet primary endpoint of OS

Preceding treatment

• Surgery

Chemotherapy

• Fluorouracil (5-FU) as follows:
  • Cycle 1: 450 mg/m² IV bolus once per day on days 1 to 5
  • Cycles 2 to 49: 450 mg/m² IV bolus once on day 1

28-day course, then 7-day cycle for 48 cycles (1 year total)

References

1. Li MC, Ross ST. Chemoprophylaxis for patients with colorectal cancer: prospective study with five-year follow-up. JAMA. 1976 Jun 28;235(26):2825-8. link to original article PubMed
2. ABCSG Study 90: Schippinger W, Jagoditsch M, Sorré C, Gnant M, Steger G, Hausmaninger H, Mlineritsch B, Schaberl-Moser R, Mischinger HJ, Hofbauer F, Holzberger P, Mittlböck M, Jakesz R; ABCSG. A prospective randomised trial to study the role of levamisole and interferon alfa in an adjuvant therapy with 5-FU for stage III colon cancer. Br J Cancer. 2005 May 9;92(9):1655-62. link to original article link to PMC article contains dosing details in manuscript PubMed
3. IGCS-COL: De Placido S, Lopez M, Carlomagno C, Paoletti G, Palazzo S, Manzione L, Iannace C, Ianniello GP, De Vita F, Ficorella C, Farris A, Pistillucci G, Gemini M, Cortesi E, Adamo V, Gebbia N, Palmeri S, Gallo C, Perrone F, Persico G, Bianco AR. Modulation of 5-fluorouracil as adjuvant systemic chemotherapy in colorectal cancer: the IGCS-COL multicentre, randomised, phase III study. Br J Cancer. 2005 Oct 17;93(8):896-904. link to original article link to PMC article contains dosing details in manuscript PubMed

Fluorouracil & Levamisole

Regimen variant #1, 6 months

Study	Dates of enrollment	Evidence	Comparator	Comparative Efficacy
O'Connell et al. 1998	NR	Phase 3 (C)	FULV & Levamisole	Inferior OS
Nordlinger et al. 2005 (FFCD 9204)	1993-1998	Phase 3 (C)	5-FU, LEV, regional chemotherapy	Did not meet primary endpoint of OS60

Preceding treatment

• Surgery

Chemotherapy

• Fluorouracil (5-FU) as follows:
  • Cycle 1: 450 mg/m² IV once per day on days 1 to 5
  • Cycles 2 to 12: 450 mg/m² IV once per day on days 1 & 8

Immunotherapy

• Levamisole (Ergamisol) as follows:
  • Cycle 1: 50 mg PO three times per day on days 1 to 3, 15 to 17
  • Cycles 2 to 12: 50 mg PO three times per day on days 1 to 3

28-day course, then 14-day cycle for 11 cycles

Regimen variant #2, 12 months

Study	Dates of enrollment	Evidence	Comparator	Comparative Efficacy
Laurie et al. 1989	NR	Phase 3 (E-RT-esc)	1. Observation	Seems to have superior OS
			2. Levamisole	Not reported
Moertel et al. 1990 (SWOG S8591)	1984-1987	Phase 3 (E-RT-esc)	1. Observation	Superior OS
			2. Levamisole	Not reported
O'Connell et al. 1998	NR	Phase 3 (C)	FULV & Levamisole	Inferior OS
Wolmark et al. 1999 (NSABP C-04)	1989-07 to 1990-12	Phase 3 (C)	1. FULV	Might have inferior OS
			2. FULV & Levamisole	Not reported
Taal et al. 2001	1991-1996	Phase 3 (E-esc)	Observation	Superior OS
Glimelius et al. 2005	1991-1997	Phase 3 (E-esc)	Observation	Did not meet primary endpoint of OS
Schippinger et al. 2005 (ABCSG Study 90)	1991-1999	Phase 3 (E-esc)	1. 5-FU 2. 5-FU & IFN alfa	Inferior OS (primary endpoint)
			3. 5-FU, IFN alfa, Levamisole	Did not meet primary endpoint of OS
Martenson et al. 2004 (INT-0130)	1992-1996	Phase 3 (C)	5-FU, LEV, RT	Did not meet primary endpoint of OS
Dencausse et al. 2002	1993-1997	Randomized (C)	FULV	Did not meet co-primary endpoints of DFS/OS

Note: there was no statistical difference in the overall population of Glimelius et al. 2005; stage III patients appeared to derive benefit.

Preceding treatment

• Surgery

Chemotherapy

• Fluorouracil (5-FU) as follows:
  • Cycle 1: 450 mg/m² IV once per day on days 1 to 5
  • Cycles 2 to 25: 450 mg/m² IV once per day on days 1 & 8

Immunotherapy

• Levamisole (Ergamisol) as follows:
  • Cycle 1: 50 mg PO three times per day on days 1 to 3, 15 to 17
  • Cycles 2 to 25: 50 mg PO three times per day on days 1 to 3

28-day course, then 14-day cycle for 24 cycles (1 year total)

References

1. Laurie JA, Moertel CG, Fleming TR, Wieand HS, Leigh JE, Rubin J, McCormack GW, Gerstner JB, Krook JE, Malliard J, Twito DI, Morton RF, Tschetter LK, Barlow JF; The North Central Cancer Treatment Group and the Mayo Clinic. Surgical adjuvant therapy of large-bowel carcinoma: an evaluation of levamisole and the combination of levamisole and fluorouracil. J Clin Oncol. 1989 Oct;7(10):1447-56. link to original article contains dosing details in abstract PubMed
2. SWOG S8591: Moertel CG, Fleming TR, Macdonald JS, Haller DG, Laurie JA, Goodman PJ, Ungerleider JS, Emerson WA, Tormey DC, Glick JH, Veeder MH, Mailliard JA. Levamisole and fluorouracil for adjuvant therapy of resected colon carcinoma. N Engl J Med. 1990 Feb 8;322(6):352-8. link to original article contains dosing details in manuscript PubMed
   1. Update: Moertel CG, Fleming TR, Macdonald JS, Haller DG, Laurie JA, Tangen CM, Ungerleider JS, Emerson WA, Tormey DC, Glick JH, Veeder MH, Mailliard JA. Fluorouracil plus levamisole as effective adjuvant therapy after resection of stage III colon carcinoma: a final report. Ann Intern Med. 1995 Mar 1;122(5):321-6. link to original article PubMed
3. O'Connell MJ, Laurie JA, Kahn M, Fitzgibbons RJ Jr, Erlichman C, Shepherd L, Moertel CG, Kocha WI, Pazdur R, Wieand HS, Rubin J, Vukov AM, Donohue JH, Krook JE, Figueredo A. Prospectively randomized trial of postoperative adjuvant chemotherapy in patients with high-risk colon cancer. J Clin Oncol. 1998 Jan;16(1):295-300. link to original article contains dosing details in manuscript PubMed
4. NSABP C-04: Wolmark N, Rockette H, Mamounas E, Jones J, Wieand S, Wickerham DL, Bear HD, Atkins JN, Dimitrov NV, Glass AG, Fisher ER, Fisher B. Clinical trial to assess the relative efficacy of fluorouracil and leucovorin, fluorouracil and levamisole, and fluorouracil, leucovorin, and levamisole in patients with Dukes' B and C carcinoma of the colon: results from National Surgical Adjuvant Breast and Bowel Project C-04. J Clin Oncol. 1999 Nov;17(11):3553-9. link to original article contains dosing details in manuscript PubMed NCT00425152
   1. Pooled update: Wilkinson NW, Yothers G, Lopa S, Costantino JP, Petrelli NJ, Wolmark N. Long-term survival results of surgery alone versus surgery plus 5-fluorouracil and leucovorin for stage II and stage III colon cancer: pooled analysis of NSABP C-01 through C-05: a baseline from which to compare modern adjuvant trials. Ann Surg Oncol. 2010 Apr;17(4):959-66. link to original article link to PMC article PubMed
5. Taal BG, Van Tinteren H, Zoetmulder FA; NACCP group. Adjuvant 5FU plus levamisole in colonic or rectal cancer: improved survival in stage II and III. Br J Cancer. 2001 Nov 16;85(10):1437-43. link to original article link to PMC article contains dosing details in manuscript PubMed
6. Dencausse Y, Hartung G, Sturm J, Kopp-Schneider A, Hagmüller E, Wojatschek C, Lindemann H, Fritze D, Queisser W. Adjuvant chemotherapy in stage III colon cancer with 5-fluorouracil and levamisole versus 5-fluorouracil and leucovorin. Oncology. 2002 Oct; 25 (5): 426-30. link to original article PubMed
7. INT-0130: Martenson JA Jr, Willett CG, Sargent DJ, Mailliard JA, Donohue JH, Gunderson LL, Thomas CR Jr, Fisher B, Benson AB 3rd, Myerson R, Goldberg RM. Phase III study of adjuvant chemotherapy and radiation therapy compared with chemotherapy alone in the surgical adjuvant treatment of colon cancer: results of intergroup protocol 0130. J Clin Oncol. 2004 Aug 15;22(16):3277-83. Epub 2004 Jul 12. link to original article contains dosing details in manuscript PubMed
8. Glimelius B, Dahl O, Cedermark B, Jakobsen A, Bentzen SM, Starkhammar H, Grönberg H, Hultborn R, Albertsson M, Påhlman L, Tveit KM; Nordic Gastrointestinal Tumour Adjuvant Therapy Group. Adjuvant chemotherapy in colorectal cancer: a joint analysis of randomised trials by the Nordic Gastrointestinal Tumour Adjuvant Therapy Group. Acta Oncol. 2005;44(8):904-12. Erratum in: Acta Oncol. 2006;45(1):110. link to original article contains dosing details in manuscript PubMed
   1. Update: Dahl O, Fluge Ø, Carlsen E, Wiig JN, Myrvold HE, Vonen B, Podhorny N, Bjerkeset O, Eide TJ, Halvorsen TB, Tveit KM; Norwegian Gastrointestinal Cancer Group. Final results of a randomised phase III study on adjuvant chemotherapy with 5 FU and levamisol in colon and rectum cancer stage II and III by the Norwegian Gastrointestinal Cancer Group. Acta Oncol. 2009;48(3):368-76. link to original article PubMed
9. ABCSG Study 90: Schippinger W, Jagoditsch M, Sorré C, Gnant M, Steger G, Hausmaninger H, Mlineritsch B, Schaberl-Moser R, Mischinger HJ, Hofbauer F, Holzberger P, Mittlböck M, Jakesz R; ABCSG. A prospective randomised trial to study the role of levamisole and interferon alfa in an adjuvant therapy with 5-FU for stage III colon cancer. Br J Cancer. 2005 May 9;92(9):1655-62. link to original article link to PMC article contains dosing details in manuscript PubMed
10. FFCD 9204: Nordlinger B, Rougier P, Arnaud JP, Debois M, Wils J, Ollier JC, Grobost O, Lasser P, Wals J, Lacourt J, Seitz JF, Guimares dos Santos J, Bleiberg H, Mackiewickz R, Conroy T, Bouché O, Morin T, Baila L, van Cutsem E, Bedenne L. Adjuvant regional chemotherapy and systemic chemotherapy versus systemic chemotherapy alone in patients with stage II-III colorectal cancer: a multicentre randomised controlled phase III trial. Lancet Oncol. 2005 Jul;6(7):459-68. link to original article contains dosing details in manuscript PubMed

FULV & Levamisole

FULV & Levamisole: 5-FU, LeucoVorin, Levamisole

Regimen variant #1, 5-FU 370 x 6 months

Study	Dates of enrollment	Evidence	Comparator	Comparative Efficacy
O'Connell et al. 1998	NR	Phase 3 (E-esc)	5-FU & Levamisole	Superior OS

Preceding treatment

• Surgery

Chemotherapy

• Fluorouracil (5-FU) 370 mg/m² IV push once per day on days 1 to 5, given second
• Leucovorin (Folinic acid) 20 mg/m² IV push once per day on days 1 to 5, given first

Immunotherapy

• Levamisole (Ergamisol) 50 mg PO three times per day on days 1 to 3, 15 to 17

28-day cycle for 2 cycles, then 35-day cycle for 4 cycles

Regimen variant #2, 5-FU 425 x 6 months

Study	Dates of enrollment	Evidence	Comparator	Comparative Efficacy
Poplin et al. 2005 (SWOG S9415)	1994-1999	Phase 3 (C)	5-FU & Levamisole; CIFU	Did not meet primary endpoint of OS

Preceding treatment

• Surgery

Chemotherapy

• Fluorouracil (5-FU) 425 mg/m² IV push once per day on days 1 to 5, given second
• Leucovorin (Folinic acid) 20 mg/m² IV push once per day on days 1 to 5, given first

Immunotherapy

• Levamisole (Ergamisol) as follows:
  • Cycles 1 & 2: 50 mg PO three times per day on days 1 to 3, 15 to 17
  • Cycles 3 & 5: 50 mg PO three times per day on days 1 to 3, 15 to 17, 29 to 31
  • Cycles 4 & 6: 50 mg PO three times per day on days 8 to 10, 22 to 24

28-day cycle for 2 cycles, then 35-day cycle for 4 cycles

Regimen variant #3, 12 months

Study	Dates of enrollment	Evidence	Comparator	Comparative Efficacy
O'Connell et al. 1998	NR	Phase 3 (E-esc)	5-FU & Levamisole	Superior OS

Preceding treatment

• Surgery

Chemotherapy

• Fluorouracil (5-FU) 370 mg/m² IV push once per day on days 1 to 5, given second
• Leucovorin (Folinic acid) 20 mg/m² IV push once per day on days 1 to 5, given first

Immunotherapy

• Levamisole (Ergamisol) 50 mg PO three times per day on days 1 to 3, 15 to 17

28-day cycle for 2 cycles, then 35-day cycle for 10 cycles

References

1. O'Connell MJ, Laurie JA, Kahn M, Fitzgibbons RJ Jr, Erlichman C, Shepherd L, Moertel CG, Kocha WI, Pazdur R, Wieand HS, Rubin J, Vukov AM, Donohue JH, Krook JE, Figueredo A. Prospectively randomized trial of postoperative adjuvant chemotherapy in patients with high-risk colon cancer. J Clin Oncol. 1998 Jan;16(1):295-300. link to original article contains dosing details in manuscript PubMed
2. NSABP C-04: Wolmark N, Rockette H, Mamounas E, Jones J, Wieand S, Wickerham DL, Bear HD, Atkins JN, Dimitrov NV, Glass AG, Fisher ER, Fisher B. Clinical trial to assess the relative efficacy of fluorouracil and leucovorin, fluorouracil and levamisole, and fluorouracil, leucovorin, and levamisole in patients with Dukes' B and C carcinoma of the colon: results from National Surgical Adjuvant Breast and Bowel Project C-04. J Clin Oncol. 1999 Nov;17(11):3553-9. link to original article PubMed
   1. Pooled update: Wilkinson NW, Yothers G, Lopa S, Costantino JP, Petrelli NJ, Wolmark N. Long-term survival results of surgery alone versus surgery plus 5-fluorouracil and leucovorin for stage II and stage III colon cancer: pooled analysis of NSABP C-01 through C-05: a baseline from which to compare modern adjuvant trials. Ann Surg Oncol. 2010 Apr;17(4):959-66. link to original article link to PMC article PubMed
3. SWOG S9415: Poplin EA, Benedetti JK, Estes NC, Haller DG, Mayer RJ, Goldberg RM, Weiss GR, Rivkin SE, Macdonald JS. Phase III Southwest Oncology Group 9415/Intergroup 0153 randomized trial of fluorouracil, leucovorin, and levamisole versus fluorouracil continuous infusion and levamisole for adjuvant treatment of stage III and high-risk stage II colon cancer. J Clin Oncol. 2005 Mar 20;23(9):1819-25. link to original article contains dosing details in manuscript PubMed NCT00002593
4. IGCS-COL: De Placido S, Lopez M, Carlomagno C, Paoletti G, Palazzo S, Manzione L, Iannace C, Ianniello GP, De Vita F, Ficorella C, Farris A, Pistillucci G, Gemini M, Cortesi E, Adamo V, Gebbia N, Palmeri S, Gallo C, Perrone F, Persico G, Bianco AR. Modulation of 5-fluorouracil as adjuvant systemic chemotherapy in colorectal cancer: the IGCS-COL multicentre, randomised, phase III study. Br J Cancer. 2005 Oct 17;93(8):896-904. link to original article link to PMC article PubMed

mFOLFOX6-B

mFOLFOX6-B: FOLinic acid (Leucovorin), Fluorouracil, OXaliplatin, Bevacizumab

Regimen

Study	Dates of enrollment	Evidence	Comparator	Comparative Efficacy
Allegra et al. 2009 (NSABP C-08)	2004-2006	Phase 3 (E-esc)	mFOLFOX6	Did not meet primary endpoint of DFS1 DFS36: 77.9% vs 75.1% (HR 0.93, 95% CI 0.81-1.08)

¹Reported efficacy is based on the 2013 update.
Note: this was a negative experimental arm but is included for historic reference. Some guidelines do not recommend using bevacizumab as adjuvant therapy outside of a clinical trial.

Preceding treatment

• Surgery

Chemotherapy

• Fluorouracil (5-FU) 400 mg/m² IV bolus once on day 1, then 2400 mg/m² IV continuous infusion over 46 to 48 hours (total dose per cycle: 2800 mg/m²)
• Leucovorin (Folinic acid) 400 mg/m² IV over 2 hours once on day 1
• Oxaliplatin (Eloxatin) 85 mg/m² IV over 2 hours once on day 1

Targeted therapy

• Bevacizumab (Avastin) 5 mg/kg IV once on day 1

14-day cycle for 12 cycles; to start within 10 weeks of surgery

References

1. NSABP C-08: Allegra CJ, Yothers G, O'Connell MJ, Sharif S, Colangelo LH, Lopa SH, Petrelli NJ, Goldberg RM, Atkins JN, Seay TE, Fehrenbacher L, O'Reilly S, Chu L, Azar CA, Wolmark N. Initial safety report of NSABP C-08: A randomized phase III study of modified FOLFOX6 with or without bevacizumab for the adjuvant treatment of patients with stage II or III colon cancer. J Clin Oncol. 2009 Jul 10;27(20):3385-90. Epub 2009 May 4. link to original article contains dosing details in manuscript link to PMC article PubMed NCT00096278
   1. Update: Allegra CJ, Yothers G, O'Connell MJ, Sharif S, Petrelli NJ, Colangelo LH, Atkins JN, Seay TE, Fehrenbacher L, Goldberg RM, O'Reilly S, Chu L, Azar CA, Lopa S, Wolmark N. Phase III trial assessing bevacizumab in stages II and III carcinoma of the colon: results of NSABP protocol C-08. J Clin Oncol. 2011 Jan 1;29(1):11-6. Epub 2010 Oct 12. link to original article link to PMC article PubMed
   2. Update: Allegra CJ, Yothers G, O'Connell MJ, Sharif S, Petrelli NJ, Lopa SH, Wolmark N. Bevacizumab in stage II-III colon cancer: 5-year update of the National Surgical Adjuvant Breast and Bowel Project C-08 trial. J Clin Oncol. 2013 Jan 20;31(3):359-64. Epub 2012 Dec 10. link to original article link to PMC article PubMed

MOF

MOF: MeCCNU (Semustine), Oncovin (Vincristine), Fluorouracil

Regimen

Study	Dates of enrollment	Evidence	Comparator	Comparative Efficacy
Wolmark et al. 1988 (NSABP C-01)	1977-1983	Phase 3 (E-esc)	1. Observation 2. BCG	Did not meet co-primary endpoints of DFS/OS1
Wolmark et al. 1993 (NSABP C-03)	1987-1989	Phase 3 (C)	FULV	Inferior OS

¹Reported efficacy for NSABP C-01 is based on the 2004 update.

Preceding treatment

• Surgery

Chemotherapy

• Semustine (MeCCNU) 130 mg/m² PO once on day 1
• Vincristine (Oncovin) 1 mg/m² IV once per day on days 1 & 36, given first
• Fluorouracil (5-FU) 325 mg/m² IV bolus once per day on days 1 to 5, then 375 mg/m² IV bolus once per day on days 36 to 40

10-week cycle for 8 cycles

References

1. NSABP C-01: Wolmark N, Fisher B, Rockette H, Redmond C, Wickerham DL, Fisher ER, Jones J, Glass A, Lerner H, Lawrence W, Prager D, Wexler M, Evans J, Cruz A, Dimitrov N, Jochimsen P; NSABP. Postoperative adjuvant chemotherapy or BCG for colon cancer: results from NSABP protocol C-01. J Natl Cancer Inst. 1988 Mar 2;80(1):30-6. link to original article contains dosing details in manuscript PubMed
   1. Update: Smith RE, Colangelo L, Wieand HS, Begovic M, Wolmark N. Randomized trial of adjuvant therapy in colon carcinoma: 10-year results of NSABP protocol C-01. J Natl Cancer Inst. 2004 Aug 4;96(15):1128-32. link to original article PubMed
   2. Pooled update: Wilkinson NW, Yothers G, Lopa S, Costantino JP, Petrelli NJ, Wolmark N. Long-term survival results of surgery alone versus surgery plus 5-fluorouracil and leucovorin for stage II and stage III colon cancer: pooled analysis of NSABP C-01 through C-05: a baseline from which to compare modern adjuvant trials. Ann Surg Oncol. 2010 Apr;17(4):959-66. link to original article link to PMC article PubMed
2. NSABP C-03: Wolmark N, Rockette H, Fisher B, Wickerham DL, Redmond C, Fisher ER, Jones J, Mamounas EP, Ore L, Petrelli NJ, Spurr CL, Dimitrov N, Romond EH, Sutherland CM, Kardinal CG, DeFusco PA, Jochimsen P. The benefit of leucovorin-modulated fluorouracil as postoperative adjuvant therapy for primary colon cancer: results from National Surgical Adjuvant Breast and Bowel Project protocol C-03. J Clin Oncol. 1993 Oct;11(10):1879-87. link to original article contains dosing details in manuscript PubMed