Adjuvant chemotherapy in colon cancer: state of the art and future perspectives

Curr Opin Oncol. 2020 Jul;32(4):370-376. doi: 10.1097/CCO.0000000000000640.

Abstract

Purpose of review: This article will review the results of recent studies, which have investigated the duration of adjuvant chemotherapy and also suggest, which aspects of adjuvant treatment need investigation in future studies.

Recent findings: The IDEA collaboration investigated whether the duration of adjuvant chemotherapy with an oxaliplatin doublet could be reduced from 6 to 3 months. Although this study did not demonstrate noninferiority for 3 months treatment, it did show noninferiority for patients receiving 3 months CAPOX chemotherapy and for those patients with low-risk stage III disease receiving 3 months' treatment. There was also significantly less toxicity seen with 3 months' treatment. Recent studies have shown that detectable ctDNA postoperatively can predict those patients most likely to relapse and so benefit from adjuvant treatment.

Summary: It has been shown that for patients receiving adjuvant CAPOX chemotherapy, or those receiving adjuvant chemotherapy for low-risk stage III colon 3 months' chemotherapy gives similar outcomes to 6 months' treatment with significantly less toxicity.

Publication types

  • Review

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Capecitabine / administration & dosage
  • Capecitabine / adverse effects
  • Chemotherapy, Adjuvant
  • Circulating Tumor DNA / genetics
  • Colonic Neoplasms / drug therapy*
  • Colonic Neoplasms / genetics
  • Colonic Neoplasms / pathology
  • Fluorouracil / administration & dosage
  • Fluorouracil / adverse effects
  • Humans
  • Neoplasm Staging
  • Oxaliplatin / administration & dosage
  • Oxaliplatin / adverse effects
  • Randomized Controlled Trials as Topic

Substances

  • Circulating Tumor DNA
  • Oxaliplatin
  • Capecitabine
  • Fluorouracil