The ATOMIC trial has been widely celebrated as providing a positive result. However, when viewed with a lens of critical appraisal that considers issues related to overtreatment, treatment de-escalation, surrogacy, post-trial access to treatment and contributions of component, we argue that ATOMIC should not change clinical practice but rather form the basis for future trials that test de-escalation strategies.
Access to this article via Institution of Civil Engineers Library is not available. Sinicrope, F.
A. et al.
Atezolizumab plus FOLFOX for stage III mismatch repair-deficient colon cancer. N.
Engl. J.
Med. 394 , 1155–1166 (2026).
Gyawali, B. & West, H.
J. Lessons from ADAURA on adjuvant cancer drug trials: evidence, ethics, and economics.
J. Clin.
Oncol. 39 , 175–177 (2021).
André, T. et al.
Effect of duration of adjuvant chemotherapy for patients with stage III colon cancer (IDEA collaboration): final results from a prospective, pooled analysis of six randomised, phase 3 trials. Lancet Oncol.
21 , 1620–1629 (2020). Sargent, D.
J. et al.
Nature Reviews Clinical Oncology published a clinical update in Oncology on 23 Apr 2026.
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