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J Clin Oncol. 2019 Jun 1;37(16):1436-1447. doi: 10.1200/JCO.19.00281. Epub 2019 Apr 15.

Duration of Oxaliplatin-Containing Adjuvant Therapy for Stage III Colon Cancer: ASCO Clinical Practice Guideline.

Author information

1
1 University of Colorado Cancer Center, Aurora, CO.
2
2 American Society of Clinical Oncology, Alexandria, VA.
3
3 University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco, CA.
4
4 Vanderbilt University Medical Center, Nashville, TN.
5
5 University of Florida, Gainesville, FL.
6
6 BC Cancer, Vancouver, British Columbia, Canada.
7
7 Swedish Cancer Institute, Seattle, WA.
8
8 Edward Elmhurst Healthcare, Naperville, IL.
9
9 Patient Representative, Arlington, VA.
10
10 Penn Medicine, Philadelphia, PA.
11
11 Dana-Farber Cancer Institute, Boston, MA.
12
12 Stanford University Medical Center, Palo Alto, CA.
13
13 Instituto Nacional de Cancerologia, Mexico City, Mexico.
14
14 University of Texas MD Anderson Cancer Center, Houston, TX.
15
15 St Michael's Hospital, Toronto, Ontario, Canada.

Abstract

PURPOSE:

To develop recommendations for duration of adjuvant chemotherapy with a fluoropyrimidine and oxaliplatin for patients with completely resected stage III colon cancer based on the results of trials of 3 months compared with 6 months of treatment.

METHODS:

ASCO convened an Expert Panel and conducted a systematic review of relevant studies. The guideline recommendations were based on the review of evidence by the Expert Panel.

RESULTS:

Pooled data from the six International Duration Evaluation of Adjuvant Chemotherapy (IDEA) Collaboration randomized controlled trials comprise the evidence base for these guideline recommendations.

RECOMMENDATIONS:

The recommendations for therapy duration apply to patients with completely resected stage III colon cancer who are being offered adjuvant chemotherapy with oxaliplatin and a fluoropyrimidine. Recommendations are informed by the findings of a recent pooled analysis of clinical trials that compared 6 months versus 3 months of oxaliplatin-based chemotherapy. 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. In determining duration of therapy, the Expert Panel recommends a shared decision-making approach, taking into account patient characteristics, values and preferences, and other factors and including a discussion of the potential for benefit and risks of harm associated with treatment duration. Additional information is available at www.asco.org/gastrointestinal-cancer-guidelines .

PMID:
30986117
DOI:
10.1200/JCO.19.00281

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