Abstract

In Japan, adjuvant chemotherapy for colon cancer was mainly developed using oral fluoropyrimidines. However, all Japanese studies to date have failed to demonstrate a statistically significant survival benefit of adjuvant chemotherapy with a combination of uracil and tegafur (UFT) monotherapy over surgery alone in patients with stage II or III colon cancer. The non-inferiority trials comparing different oral fluoropyrimidine monotherapies showed any fluoropyrimidine except S-1 was comparable in patients with stage III colon cancer. Japanese guideline plays an important role in the distribution of the optimal adjuvant treatment. In addition, the tolerability of oxaliplatin-based adjuvant chemotherapy was confirmed, and a multigene assay was validated in Japanese patients. A global collaboration is ongoing to test whether disease-free survival with 3 months of oxaliplatin-based adjuvant chemotherapy was non-inferior to that with 6 months of identical chemotherapy in patients with stage III or high-risk stage II colon cancer and is one of the best model task forces for the coordination of future adjuvant chemotherapy regimens in patients with colon cancer. These findings and further research will help define treatment duration and patient selection criteria for the personalization of adjuvant chemotherapy for colon cancer.

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