Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2020 Sep 19;12(9):2679.
doi: 10.3390/cancers12092679.

Adjuvant Chemotherapy for Stage III Colon Cancer

Julien Taieb  1   2 , Claire Gallois  1   2
Affiliations
Review

Adjuvant Chemotherapy for Stage III Colon Cancer

Julien Taieb et al. Cancers (Basel). .

Abstract

In patients with stage III colon cancer (CC), adjuvant chemotherapy with the combination of oxapliplatin to a fluoropyrimidine (FOLFOX or CAPOX) is a standard of care. The duration of treatment can be reduced from 6 months to 3 months, depending on the regimen, for patients at low risk of recurrence, without loss of effectiveness and allowing a significant reduction in the risk of cumulative sensitive neuropathy. However, our capacity to identify patients that do really need this doublet adjuvant treatment remains limited. In fact, only 30% at the most will actually benefit from this adjuvant treatment, 50% of them being already cured by the surgery and 20% of them experiencing disease recurrence despite the adjuvant treatment. Thus, it is necessary to be able to better predict individually for each patient the risk of recurrence and the need for adjuvant chemotherapy together with the need of new treatment approaches for specific subgroups. Many biomarkers have been described with their own prognostic weight, without leading to any change in clinical practices for now. In this review, we will first discuss the recommendations for adjuvant chemotherapy, and then the different biomarkers described and the future perspectives for the management of stage III CC.

Keywords: adjuvant chemotherapy; colon cancer; prognosis.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Algorithm for adjuvant chemotherapy in stage III colorectal cancer. DPD: dihydropyrimidine dehydrogenase; LV5FU2: leucovorin 5-fluorouracil.
Figure 2
Figure 2
Prognostic markers in stage III colorectal cancer and potential targets for future treatments. Lightnings: potential targeted therapies for molecular subgroups. MSS: microsatellite stable; MSI: microsatellite instability; CEA: carcinoembryonic antigen; ctDNA: circulating tumor DNA; CIMP: CpG island methylator phenotype; HER 2: human epidermal growth factor receptor 2; EGFR: epidermal growth factor receptor; CMS: consensus molecular subtype.
See this image and copyright information in PMC

References

    1. Bray F., Ferlay J., Soerjomataram I., Siegel R.L., Torre L.A., Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J. Clin. 2018;68:394–424. doi: 10.3322/caac.21492. - DOI - PubMed
    1. Brierley J.D., Gospodarowicz M.K., Wittekind C. TNM Classification of Malignant Tumours. John Wiley & Sons; Hoboken, NJ, USA: 2017.
    1. Moertel C.G., Fleming T.R., Macdonald J.S., Haller D.G., Laurie J.A., Goodman P.J., Ungerleider J.S., Emerson W.A., Tormey D.C., Glick J.H. Levamisole and fluorouracil for adjuvant therapy of resected colon carcinoma. N. Engl. J. Med. 1990;322:352–358. doi: 10.1056/NEJM199002083220602. - DOI - PubMed
    1. André T., Boni C., Mounedji-Boudiaf L., Navarro M., Tabernero J., Hickish T., Topham C., Zaninelli M., Clingan P., Bridgewater J., et al. Oxaliplatin, fluorouracil, and leucovorin as adjuvant treatment for colon cancer. N. Engl. J. Med. 2004;350:2343–2351. doi: 10.1056/NEJMoa032709. - DOI - PubMed
    1. André T., de Gramont A., Vernerey D., Chibaudel B., Bonnetain F., Tijeras-Raballand A., Scriva A., Hickish T., Tabernero J., Van Laethem J.L., et al. Adjuvant Fluorouracil, Leucovorin, and Oxaliplatin in Stage II to III Colon Cancer: Updated 10-Year Survival and Outcomes According to BRAF Mutation and Mismatch Repair Status of the MOSAIC Study. J. Clin. Oncol. 2015;33:4176–4187. doi: 10.1200/JCO.2015.63.4238. - DOI - PubMed

LinkOut - more resources