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Clinical Practice Guideline on Duration of Oxaliplatin-Containing Adjuvant Therapy for Stage III Colon Cancer

By: Sarah Campen, PharmD
Posted: Thursday, August 1, 2019

Christopher Lieu, MD, of the University of Colorado Cancer Center, Aurora, and colleagues have developed recommendations for the duration of adjuvant chemotherapy with oxaliplatin and a fluoropyrimidine for patients with completely resected stage III colon cancer. The American Society of Clinical Oncology (ASCO) convened an Expert Panel to conduct a systematic review of pooled data from the six International Duration Evaluation of Adjuvant Chemotherapy (IDEA) Collaboration randomized controlled trials that compared 6 months versus 3 months of oxaliplatin-based chemotherapy. The evidence-based clinical practice guideline was published in the Journal of Clinical Oncology.

For patients with high-risk (T4 and/or N2) stage III resected colon cancer, the panel recommends adjuvant oxaliplatin-containing chemotherapy for a duration of 6 months. Patients with low-risk (T1, T2, or T3 and N1) stage III resected colon cancer may be offered adjuvant oxaliplatin-containing chemotherapy for a duration of 3 months or 6 months. This decision should be made after discussing with patients the potential benefits and risks of harm, such as the risk of peripheral sensory neurotoxicity, associated with the options for the treatment duration.

Additionally, the panel made a consensus-based “strong” recommendation that a shared decision-making approach should be adopted to determine the duration of oxaliplatin-containing chemotherapy for patients with low-risk stage III resected colon cancer. Physicians should take several patient-specific factors into account, including a patient’s tumor characteristics, completeness of surgical resection, number of lymph nodes examined, comorbidities, functional status, performance status, and age at diagnosis, as well as their personal values and preferences.

Disclosure: The panel members’ disclosure information can be found at ascopubs.org.



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