- The American Society of Clinical Oncology (ASCO) has issued new guidelines supporting a 3-month course of oxaliplatin-based adjuvant chemotherapy for low-risk patients with completely resected, stage III colon cancer.
Why this matters
- 6-month treatment course has been standard of care until recently, but the new guidelines incorporate data from the International Duration Evaluation of Adjuvant Chemotherapy Collaboration, which compared DFS and adverse events with varying durations of fluoropyrimidine and oxaliplatin-based chemotherapy.
- Patients at high risk for recurrence (T4 and/or N2) should be offered the therapy for 6 months (strength of recommendation: moderate).
- Patients at low risk for recurrence (T1, T2, or T3 and N1) can be offered either 6 or 3 months of adjuvant therapy, given that the shorter duration has the potential to reduce adverse events such as sensory neurotoxicity, and was associated with no significant difference in DFS (strength of recommendation: moderate).
- Shared decision-making should be used to select therapy duration and should consider patient characteristics, values and preferences, completeness of resection, number of lymph nodes examined, functional status, comorbidities, and other characteristics (strength of recommendation: strong).