Progress and challenges in the adjuvant treatment of stage II and III colon cancers

Abstract

Whereas the benefit of adjuvant 5-fluorouracil and leucovorin have been well established in resected stage III colon cancer, a significant benefit for patients with stage II disease has been more difficult to demonstrate. More recently, oxaliplatin-based chemotherapy with regimens such as oxaplatin plus 5-fluorouracil/leucovorin have been shown to improve disease-free and overall survival in these stage III patients. This review will discuss the development of adjuvant chemotherapy in colon cancer, focusing on recent progress and particular topical issues related to its use in this disease, such as the use of surrogate end points for overall survival in contemporary clinical trials.

Keywords::

• adjuvant chemotherapy
• capecitabine
• colon cancer
• disease-free survival
• fluorouracil
• leucovorin
• oxaliplatin
• prognostic factors

Financial & competing interests disclosure

Yo Jo Chua has received honoraria from Roche, Sanofi-Aventis, Amgen and Pfizer. John R Zalcberg is a Board member for Progen Pharmaceuticals, has a consultant/advisory role with Amgen, Ariad, Novartis, Pfizer, Roche and Sanofi-Aventis, owns Progen Pharmaceuticals stock, has received honoraria from Amgen, Imclone, Novartis, Pfizer, Roche and Sanofi-Aventis, has research funding from Novartis and Pfizer and has been remunerated for travel expenses by Amgen, Fulcrum, Novartis, Pfizer, Roche and Sanofi-Aventis. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.