Lycopene (tomato-carotenoid) intake linked to ~40% lower recurrence/death risk in stage III colon cancer

In a prospective cohort nested within the Phase III CALGB (Alliance)/SWOG 80702 adjuvant trial (NCT01150045), post-diagnosis lycopene (a non–provitamin A carotenoid largely derived from tomato-based foods; diet ± supplements) was assessed by FFQs at ~6 weeks and again at 14–16 months after randomization, modeled as time-varying cumulative average intake in resected stage III colon cancer (n=1666). Over median follow-up 6.0 years, highest vs lowest quintile total lycopene intake was associated with improved DFS (HR 0.60, 95% CI 0.44–0.83; Ptrend=0.006), RFS (HR 0.58, 95% CI 0.41–0.82; Ptrend=0.007), and OS (HR 0.60, 95% CI 0.40–0.89; Ptrend=0.02); dietary lycopene showed similar directionality. There were no treatment-emergent toxicity signals here (dietary exposure study), but confounding is a major concern—especially because modern adjuvant stage III colon cancer outcomes on oxaliplatin-based regimens are already strong (e.g., ~72–76% 3-year DFS with mFOLFOX6 in IDEA France; ~75–76% 3-year DFS reported for FOLFOX-era stage III cohorts), making it hard to know whether lycopene is causal vs a marker of healthier behaviors.