1. Optimizing Adjuvant Therapy for Localized Colon Cancer and Treatment Selection in Advanced Colorectal Cancer.
- Author
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Grothey A and Venook AP
- Subjects
- Antineoplastic Agents, Immunological standards, Antineoplastic Combined Chemotherapy Protocols standards, Chemotherapy, Adjuvant methods, Chemotherapy, Adjuvant standards, Colectomy standards, Colorectal Neoplasms genetics, Colorectal Neoplasms mortality, Colorectal Neoplasms pathology, DNA Mismatch Repair genetics, Disease-Free Survival, Fluorouracil standards, Fluorouracil therapeutic use, Humans, Leucovorin standards, Leucovorin therapeutic use, Medical Oncology standards, Microsatellite Instability, Mutation, Neoplasm Staging, Organoplatinum Compounds standards, Organoplatinum Compounds therapeutic use, Oxaliplatin therapeutic use, Proctectomy standards, Proto-Oncogene Proteins B-raf genetics, Randomized Controlled Trials as Topic, Societies, Medical standards, United States epidemiology, Antineoplastic Agents, Immunological therapeutic use, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Biomarkers, Tumor genetics, Colorectal Neoplasms therapy, Practice Guidelines as Topic
- Abstract
Results from the pivotal IDEA trial, which evaluated 3 versus 6 months of adjuvant oxaliplatin-based chemotherapy, are incorporated into the NCCN Guidelines for Colon Cancer. The guidelines recommend that for patients with low-risk stage III disease, the preferred regimen is CAPEOX for 3 months or FOLFOX for 3 to 6 months. For patients with high-risk stage III disease, the preferred regimen is CAPEOX for 3 to 6 months or FOLFOX for 6 months. In metastatic disease, tumor sidedness should be a consideration when choosing a biologic. For BRAF -mutated disease, several triplets are now recommended options. Importantly, for a subset of patients with metastatic disease, new to the NCCN Guidelines is the incorporation of nivolumab and pembrolizumab as subsequent therapy for those with microsatellite instability-high or mismatch repair-deficient tumors., (Copyright © 2018 by the National Comprehensive Cancer Network.)
- Published
- 2018
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