Adjuvant therapy in lymph node–positive colon cancer: Current standards and future perspectives

Abstract

Abstract The significant survival benefit for adjuvant chemotherapy after a curative resection for node-positive colon cancer has been established for over a decade. The first major step in progression, from randomized trials that failed to demonstrate benefit for postoperative single-agent fluorinated pyrimidines, came with intensive immunobiochemical modulation of 5-fluorouracil for a 1-year course. Subsequent trials confirmed equivalent benefit for a shorter course of therapy, and additional improvement in disease-free and overall survival has been sought through employment of alternative modulatory agents or drug administration schedule changes. Newer cytotoxic agents, whose mechanisms of action differ from that of the fluorinated pyrimidines, have been examined in combination with 5-FU, and changes in recommendations for standard of care, based on results of these maturing data sets, are awaited. The impact of tumor molecular profiles on therapeutic prediction and rational design of new agents is expected to inform the design of future generations of clinical trials. Copyright 2002, Elsevier Science (USA). All rights reserved.