Adjuvant chemotherapy for stages II, III and IV of colon cancer

Abstract

Colorectal cancer is the third most frequent malignant neoplasm in Western countries. After complete resection, 5-year overall survival varies according to the initial stage. Adjuvant chemotherapy (CT) is indicated in patients with colon cancer at high-risk stage II, stage III and after complete resection of metastases. 5-Fluorouracil (5FU), alone or modulated with levamisol or leucovorin (LV), oral fluoropyrimidines, raltitrexed, irinotecan and oxaliplatin have been studied as adjuvant therapy for colon cancer. Nowadays, oxaliplatin-based regimens, FOLFOX or FLOX, are considered as the standard adjuvant CT. If there are contraindications for oxaliplatin, the best alternatives are capecitabine or continuous infusion of 5FU/LV. The role of monoclonal antibodies, cetuximab and bevacizumab, combined with oxaliplatin/fluoropyrimidine-based CT is under investigation in clinical trials. This article reviews the state of the art and the future perspectives of adjuvant therapy in colon cancer. Prognostic and predictive factors are also commented on.

Cost of care for colorectal cancer in Ireland: a health care payer perspective

“…Co-administration of chemotherapy can improve response [18,19]. For colon cancer, adjuvant chemotherapy is routine for stage III disease and for many patients with advanced disease [20][21][22][23] and might also benefit stage II patients with poor prognostic features, such as lymph node involvement [23]. Over the past decade, there has been a marked increase in the complexity of chemotherapy, for example, from 5-fluorouracil (5-FU) with or without leucovorin to multi-agent regimens containing capecitabine, irinotecan or oxaliplatin.…”

First Evaluation of the Biologic Effectiveness Factors of Boron Neutron Capture Therapy (BNCT) in a Human Colon Carcinoma Cell Line

“…After a complete resection, 5-year overall survival varies according to the stage at diagnosis (28). The development of new therapies is necessary.…”

Changing Pathology with Changing Drugs: Tumors of the Gastrointestinal Tract

“…4 ) predicts a failure of response to adjuvant 5-FU monotherapy and there is no evidence of a value of MSI for a Folfox treatment combination in metastatic CRC. MSI predicts the response to adjuvant irinotecan/5FU/ leucovorin when Folfox cannot be used [40,41] . MSI status and p53 expression may influence the impact of oxaliplatin in the adjuvant treatment of stage III colon cancer patients [42] .…”