Highlights in the adjuvant treatment of colon canc

Authors: Gudrun Resch Josef Thaler

Publish Date: 2012/06/07

Volume: 5, Issue: 2, Pages: 163-166

PDF Link

Abstract

The new biologic drugs that are active in the advanced setting of colon cancer have failed when used in the adjuvant setting Both bevacizumab NSABP C08 AVANTtrial and cetuximab NO147 trial added to oxaliplatinbased chemotherapy demonstrated no improvements in 3year DFS compared with chemotherapy alone However subgroup analysis of the NO147 trial indicated that irinotecan and cetuximab might have a synergistic effect and the combination of FOLFIRI and cetuximab led to an improvement in 3year DFS and 2year OS compared with FOLFIRI alone The encouraging results of this small patient cohort have to be confirmed by prospective trials The use of adjuvant chemotherapy in stage II colon cancer remains controversial Fluoropyrimidinebased chemotherapy should be discussed in highrisk stage II patients The addition of oxaliplatin to fluoropyrimidine shows a trend toward improvement in DFS and OS at 5 years in patients with highrisk stage II colon cancer In our opinion this combination should be applied only in exceptional cases such as younger patients with accumulation of risk factors Prognostic classifier like ColoPrint might identify highrisk patients who will benefit from chemotherapy on the basis of gene expression information in the primary tumor

Keywords: