Retrospective analysis of dose intensity, toxicity, and clinical outcomes in 5-fluorouracil based regimens in the treatment of metastatic colorectal cancer.
Bibliographic record
Abstract
e14595 Background: Metastatic colorectal cancer (mCRC) chemotherapy utilizes either sequential monotherapy followed by combination therapy or early combination therapies. Patients receive therapy consisting of oxaliplatin with 5-FU as an intravenous formulation (FOLFOX6) or capecitabine (CAPOX). A retrospective analysis was performed comparing average relative dose intensity (ARDI), overall survival (OS), progression free survival (PFS), and toxicity profiles of these 2 regimens in mCRC patients. Methods: 122 mCRC patients identified between January 1, 2006 and December 31, 2011 received either FOLFOX6 (n= 46) or CAPOX (n=76) in Edmonton, Alberta. ARDI was compared by calculating a percent of target dose achieved in the average cycle for each patient. Data on OS, PFS, baseline demographics, and toxicities was gathered. Survival data was plotted using the Kaplan-Meier method and compared using the log-rank test. Variable comparisons were performed with the Student’s t-test or the Fisher’s Exact test. Follow up was complete until November 1, 2012. Results: Oxaliplatin ARDI trended towards being lower in those treated with CAPOX compared to FOLFOX6 (84.01 vs 89.52 p=0.0553), and 5-FU component was significantly lower (81.28 vs 95.76, p<0.0001). More patients treated with CAPOX had dose limiting toxicities (DLTs), although not statistically significant (68.42% vs 54.35%, p=0.1268), while toxicities of grade 2 and higher were increased with CAPOX (38.16% of patients vs 15.22%, p=0.0079). Neuropathy rates were similar between regimens as were cycle numbers were completed between CAPOX and FOLFOX6 (5.329 vs 6.174, p=0.2796). Survival analysis demonstrated trends towards improved median OS (300 vs 227 days, p=0.1183) and median PFS (132 vs 101.5 days, p=0.1674) with CAPOX. The groups had similar age, gender, and ECOG at diagnosis. Conclusions: Patients treated with CAPOX had significantly more DLTs resulting in lower doses of oxaliplatin and capecitabine compared to FOLFOX6. This does not seem to impact clinical outcomes as mCRC patients on CAPOX showed a trend toward improved outcomes compared to FOLFOX6.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".