Practice-entering research
ATOMIC — adjuvant atezolizumab + mFOLFOX6 in stage III dMMR colon cancer
Randomized Trial of Standard Chemotherapy Alone or Combined With Atezolizumab as Adjuvant Therapy for Patients With Stage III Colon Cancer and Deficient DNA Mismatch Repair
- Phase
- Phase III
- Recruitment
- Active, not recruiting
- Results maturity
- Primary analysis
- Publication
- Peer-reviewed
- Regulatory approval
- FDA approval — 8 October 2026 (US)
- NCT
- NCT02912559
- Registry checked
- 2026-10-29
- Editorial update
- 2026-10-29
Not a treatment recommendation. Experimental or ongoing research does not by itself replace standard care.
For patients
What is being studied? In some genetically defined (dMMR) stage III colon cancers, immunotherapy plus chemotherapy after surgery may reduce recurrence versus chemotherapy alone. Side effects may increase. An FDA-approved option exists in the US for this indication; the situation in Turkey is separate.
Why promising? Adjuvant atezolizumab + mFOLFOX6 improved DFS versus mFOLFOX6 alone in stage III dMMR colon cancer (NEJM 2026). FDA approval — 8 October 2026 (US); not an accelerated approval.
What is not proven? Mature OS superiority is not clearly separated (HR 0.90; not significant). No generalization to pMMR colon. Grade 3–4 AEs increased. Turkey license and reimbursement must be verified separately. HR 0.50 is relative event rate — not a 50% absolute risk reduction (absolute DFS difference ~10.1 percentage points).
Is this standard care today? In the US, adjuvant atezolizumab plus fluoropyrimidine/oxaliplatin is an FDA-approved option for eligible stage III dMMR colon cancer (8 October 2026). That does not make it automatic standard care everywhere. Turkey license, reimbursement, and institutional protocol must be verified separately; toxicity–benefit balance and OS maturity require clinician judgment.
For clinicians
n=712; 3y DFS 86.3% vs 76.2% (absolute difference 10.1 points; HR 0.50; 95% CI 0.35–0.73; P<0.001). Grade 3–4 AE 84.1% vs 71.9%. OS not significantly different (HR 0.90). FDA approval — 8 Oct 2026 (US): Tecentriq ± Hybreza + fluoropyrimidine/oxaliplatin, stage III dMMR (regular approval, not AA). Primary home is Colon Landmark Atlas; this module is a bridge and does not award gold stars.
Cancer / population: Colon — Rezeke evre III dMMR kolon adenokarsinomu
Intervention: Atezolizumab + mFOLFOX6 → atezolizumab idame
Primary endpoint: Hastalıksız sağkalım (DFS)
Source-verified summary: NEJM primary DFS: 3y 86.3% vs 76.2%; HR 0.50 (95% CI 0.35–0.73). FDA approval — 2026-10-08 (US), regular (not accelerated). Landmark altın yıldız 2026-10-29.
Limitations: OS henüz olgun ayrışmamış; AE artışı; Türkiye ruhsat/geri ödeme UNVERIFIED; kılavuz yerleşimi izlenmeli.
Landmark Atlas links
Cross-links are informational only; this module does not award or change gold stars.