Largest colon cancer chemo guideline changes since 2004: 6 things to know

According to Medscape, the National Comprehensive Cancer Network's colon cancer guidelines have changed to reflect that patients with low-risk stage III colon cancers can be treated with a shorter schedule of adjuvant chemotherapy, the largest change to the guidelines since 2004.

Here are six things to know.

1. The change is due to International Duration Evaluation of Adjuvant Chemotherapy collaboration results, which compared three months of treatment with the standard of six months of oxaliplatin-based chemotherapy regimens. Treatment was either leucovorin, fluorouracil, oxaliplatin — Folfox — or capecitabine/oxaliplatin — Capeox, also known as Xelox.

2. The results were presented at the 2017 American Society of Clinical Oncology annual meeting, where it was announced they would be published in the New England Journal of Medicine.

3. The treatment recommendations define low-risk stage III as pathologic stages T1-3N1. For these patients, the preferred treatments are CAPEOX for three months or FOLFOX for three to six months.

4. The recommendations define high-risk stage III disease as pathologic stages T4N1-2 and AnyTN2. For these patients, the preferred treatments are CAPEOX for three to six months or FOLFOX for six months.

5. Researchers claimed the shorter duration leads to reduced toxicity and that there are a great number of patients who can be treated with less chemotherapy.

6. In the U.S., 20,000 patients have low-risk stage III tumors per year.

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