The American Society of Clinical Oncology (ASCO) has released a new guideline that states that patients with clinically low-risk stage III colon cancer should have the option of receiving 3 months of adjuvant oxaliplatin-based chemotherapy.
The clinical practice guideline was published in the Journal of Clinical Oncology (online April 15, 2019; doi:10.1200/JCO.19.00281).
An expert panel of 15 individuals convened and conducted a systematic review of relevant studies – including pooled data from the six randomized International Duration Evaluation of Adjuvant Chemotherapy (IDEA) collaboration, which compared 3 months vs 6 months of adjuvant therapy in patients with completely resected colon cancer.
Resulting recommendations of therapy duration apply to patients with completely resected stage III colon cancer who are being offered adjuvant chemotherapy with oxaliplatin and a fluoropyrimidine.
For patients at a high risk of recurrence (T4 and/or N2), adjuvant chemotherapy should be offered for a duration of 6 months.
For patients at a low risk of recurrence (T1, T2, or T3 and N1), either 6 months of adjuvant chemotherapy or a shorter duration of 3 months may be offered on the basis of a potential reduction in adverse events and no significant difference in disease-free survival with the 3-month regimen.
Furthermore, the panel recommends a shared decision-making approach on a case-by-case basis in determining duration of therapy. Decision-makers should take into account patient characteristics, values and preferences, and other factors including a discussion of the potential for benefit and risks of harm associated with treatment duration, the guideline states.—Zachary Bessette