Three Versus 6 Months of Adjuvant Oxaliplatin-Fluoropyrimidine Chemotherapy for Colorectal Cancer: Final Results of SCOT—An International, Randomized, Phase III, Noninferiority Trial

Adjuvant chemotherapy for colorectal cancer (CRC) with oxaliplatin and fluoropyrimidine was traditionally given for 6 months but is associated with cumulative peripheral neuropathy. The SCOT study (ISRCTN59757862) was an international, randomized, phase III, noninferiority trial investigating treatment reduction from 6 to 3 months. It originally reported noninferior disease-free survival with reduced toxicity and improved quality of life for 3 months of treatment in 6,088 patients. Here, we report overall survival (OS) with 38 months of additional follow-up. Patients with high-risk stage II and stage III CRC were assigned (1:1) to receive 3 or 6 months of either capecitabine and oxaliplatin (CAPOX) or infusional fluorouracil, leucovorin, and oxaliplatin (FOLFOX; bolus and infused fluorouracil with oxaliplatin) that were selected before random assignment. With a median of 113 months follow-up and 1,255 OS events, 5-year OS for 3 versus 6 months of treatment was 82.4% in both groups (hazard ratio, 0.96; 95% CI, 0.8 to 1.07), proving noninferiority of 3 months of treatment. Noninferiority of 3 months of treatment for OS was also shown in 1,087 patients with rectal cancer. The duration effect is regimen-dependent with noninferiority shown for CAPOX but not for FOLFOX. In summary, SCOT has shown noninferiority for OS with 3 months of adjuvant chemotherapy treatment, which should be recommended for most patients.

Authors

Institutions

Publication Details

Journal
Journal of Clinical Oncology
Published
2026-01-09
DOI
https://doi.org/10.1200/jco-25-00621
Primary Topic
Colorectal Cancer Treatments and Studies
Type
article
Field-Weighted Citation Impact
0.00
Controls
|||
ALL TIME
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
article

Three Versus 6 Months of Adjuvant Oxaliplatin-Fluoropyrimidine Chemotherapy for Colorectal Cancer: Final Results of SCOT—An International, Randomized, Phase III, Noninferiority Trial

Stephen Falk, Josep M. Tabernero, A.S. Dhadda, Andrew Briggs et al.
Journal of Clinical Oncology
Colorectal Cancer Treatments and Studies
article

Three Versus 6 Months of Adjuvant Oxaliplatin-Fluoropyrimidine Chemotherapy for Colorectal Cancer: Final Results of SCOT—An International, Randomized, Phase III, Noninferiority Trial

Stephen Falk, Josep M. Tabernero, A.S. Dhadda, Andrew Briggs, M. Saunders, Tamas Hickish, Rene K Olesen, David Propper, E. Domingo, Jim Cassidy, Timothy Iveson, H Wasan, Niels Henrik Holländer, K. Boyd, Sarah Pearson, John McQueen, Andrew Haydon, Richard Ellis, David Church, Bengt Glimelius, Charlotte Rees, David Cunningham, Rachel S. Kerr, Simon Gollins, Mark Harrison, Caroline Kelly, Ashraf Azzabi, Karen Allan, John Bridgewater, Ashita Waterston
article en

Abstract

Adjuvant chemotherapy for colorectal cancer (CRC) with oxaliplatin and fluoropyrimidine was traditionally given for 6 months but is associated with cumulative peripheral neuropathy. The SCOT study (ISRCTN59757862) was an international, randomized, phase III, noninferiority trial investigating treatment reduction from 6 to 3 months. It originally reported noninferior disease-free survival with reduced toxicity and improved quality of life for 3 months of treatment in 6,088 patients. Here, we report overall survival (OS) with 38 months of additional follow-up. Patients with high-risk stage II and stage III CRC were assigned (1:1) to receive 3 or 6 months of either capecitabine and oxaliplatin (CAPOX) or infusional fluorouracil, leucovorin, and oxaliplatin (FOLFOX; bolus and infused fluorouracil with oxaliplatin) that were selected before random assignment. With a median of 113 months follow-up and 1,255 OS events, 5-year OS for 3 versus 6 months of treatment was 82.4% in both groups (hazard ratio, 0.96; 95% CI, 0.8 to 1.07), proving noninferiority of 3 months of treatment. Noninferiority of 3 months of treatment for OS was also shown in 1,087 patients with rectal cancer. The duration effect is regimen-dependent with noninferiority shown for CAPOX but not for FOLFOX. In summary, SCOT has shown noninferiority for OS with 3 months of adjuvant chemotherapy treatment, which should be recommended for most patients.

Journal of Clinical OncologyVol. 44(7)
Hebron University (PS), Uppsala University (SE), Queen Mary University of London (GB), Royal Cornwall Hospital Trust (GB), Beatson West of Scotland Cancer Centre (GB), Royal United Hospital (GB), Castle Hill Hospital (GB), Newcastle upon Tyne Hospitals NHS Foundation Trust (GB), Hammersmith Hospital (GB), The Alfred Hospital (AU), Aarhus University Hospital (DK), University Hospital Southampton NHS Foundation Trust (GB), University of Oxford (GB), Zealand University Hospital (DK), Mount Vernon Cancer Centre (GB), Royal Marsden Hospital (GB), The Christie Hospital (GB), NIHR Bristol Cardiovascular Biomedical Research Unit (GB), UCL Biomedical Research Centre (GB), Science Oxford (GB), Velindre Cancer Centre (GB), University of Southampton (GB), University College London (GB), Imperial College London (GB), University of Glasgow (GB), Bournemouth University (GB)
Openalex Percentile: Top 93%
Colorectal Cancer Treatments and Studies
DOIOpen Access PDFOpenAlex
AI Navigator

Ask Laika to Summarize, Analyze, and Connect papers live on the map.

Summarize Papers & Methodologies

Extract key findings, datasets, and comparative methods across publications.

Benchmark Rankings & Visual Analytics

Rank top research institutions, authors, funders, topics, and journals by Field-Weighted Citation Impact (FWCI) and paper volume with instant charts.

Connect Distant Disciplines

Bridge topological clusters on the map to find hidden collaborative intersections.