FOLFOX4 in the adjuvant treatment of colon cancer in Asian patients

Abstract

Colorectal cancer (CRC) is a leading cause of cancer death worldwide. Surgery is the only way to potentially cure the disease and may be accomplished in 70% to 80% of newly diagnosed cases. However, 40% to 50% of patients who undergo surgery alone ultimately relapse and die of metastatic disease. Adjuvant chemotherapy, which has been developed to reduce the recurrence of CRC, has evolved from the single agent fluorouracil (5FU) to combinations with oxaliplatin, which now have an established role in stage III CRC. FOLFOX4 has been widely used as an adjuvant treatment of CRC, including the Asia-Pacific region. Adjuvant chemotherapy for CRC has been extensively investigated in the West but whether treatment outcomes in Asian individuals vary due to racial differences is uncertain. Racial differences should be considered, and differences in outcomes have been shown in patients with non-small cell lung cancer (NSCLC) treated with epidermal growth factor receptor tyrosine kinase inhibitors. This article critically reviews the evolution of adjuvant chemotherapy in CRC and focuses on the side effects of FOLFOX4 when administered to Asian patients for the adjuvant treatment of CRC. Comparisons of the tolerability of FOLFOX4 in different races from well-designed studies conducted in the West and Asia will be reviewed.