What are the NCCN-recommended adjuvant therapy regimens for colon cancer?

Updated: Apr 15, 2020
  • Author: Tomislav Dragovich, MD, PhD; Chief Editor: N Joseph Espat, MD, MS, FACS  more...
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National Comprehensive Cancer Network (NCCN) guidelines list numerous adjuvant therapy regimens for colon cancer. Regimens for metastatic colon cancer include molecular-targeted agents chosen on the basis of testing for KRAS, NRAS, and BRAF mutations. [93]

NCCN preferred regimens for adjuvant therapy for patients with resected, nonmetastatic colon cancer depend on the stage of disease, as follows:

  • Stage I disease and low-risk stage II disease with high microsatellite instability (MSI-H): No adjuvant therapy required; patients with low-risk stage II disease can be enrolled in a clinical trial, observed without adjuvant therapy, or considered for capecitabine or 5-fluorouracil (FU)/leucovorin (LV).
  • High-risk stage II disease: 5-FU/LV, capecitabine, FOLFOX (5-FU, LV, oxaliplatin), capecitabine/oxaliplatin (CapeOx), or bolus 5-FU/LV/oxaliplatin (FLOX); observation without adjuvant therapy is also an option
  • Low-risk stage III (pathologic stages T1-3/N1): CapeOx for 3 months or FOLFOX for 3 to 6 months.
  • High-risk stage III disease (pathologic stages T4/N1-2 and anyT/N2): CapeOx for 3 to 6 months or FOLFOX for 6 months

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