DOI QR코드

DOI QR Code

Adjuvant Chemotherapy in Colon Cancer

대장암의 보조항암화학요법

  • Cho, Sang-Hee (Division of Hematooncology, Department of Internal Medicine, Chonnam National University Medical School)
  • 조상희 (전남대학교 의과대학 혈액종양내과)
  • Published : 2012.09.01

Abstract

Colorectal cancer represents a major public health problem in worldwide including Korea. According to the National Cancer Registry, colon cancer is the third most common cancer and the forth leading cause of cancer death. The surgery is a main treatment option for cure. Despite curative surgery in those presenting early, the risk of relapse is significantly high. To improve the survival, huge advances have been made in the treatment of colon cancer over the last decade. Especially, the median overall survival time for stage IV colon cancer has been reached from 6-9 months to over 20 months. Based on these results, drugs such as irinotecan, oxaliplatin and oral fluoropyrimidine have been used to evaluate the efficacy in adjuvant setting. Oxaliplatin based chemotherapy is now emerging as the standard of care in adjuvant treatment of stage III colon cancer. Targeted agents, which have shown promise in the metastatic setting, are currently being examined in the adjuvant setting, although results have been disappointing until now. Even though adjuvant treatment is recommended for 'high risk' stage II, the endeavor to answer for question-who should be treated by what-is needed.

Keywords

References

  1. Gill S, Loprinzi CL, Sargent DJ, et al. Pooled analysis of fluorouracil-based adjuvant therapy for stage II and III colon cancer: who benefits and by how much? J Clin Oncol 2004;22:1797-1806. https://doi.org/10.1200/JCO.2004.09.059
  2. NIH consensus conference. Adjuvant therapy for patients with colon and rectal cancer. JAMA 1990;264:1444-1450. https://doi.org/10.1001/jama.1990.03450110090034
  3. Wolmark N, Fisher B, Rockette H, et al. Postoperative adjuvant chemotherapy or BCG for colon cancer: results from NSABP protocol C-01. J Natl Cancer Inst 1988;80: 30-36. https://doi.org/10.1093/jnci/80.1.30
  4. Di Costanzo F, Sobrero A, Gasperoni S, et al. Adjuvant chemotherapy in the treatment of colon cancer: randomized multicenter trial of the Italian National Intergroup of Adjuvant Chemotherapy in Colon Cancer (INTACC). Ann Oncol 2003;14:1365-1372. https://doi.org/10.1093/annonc/mdg359
  5. Link KH, Kornmann M, Staib L, Redenbacher M, Kron M, Beger HG. Increase of survival benefit in advanced resectable colon cancer by extent of adjuvant treatment: results of a randomized trial comparing modulation of 5-FU + levamisole with folinic acid or with interferon-alpha. Ann Surg 2005;242:178-187. https://doi.org/10.1097/01.sla.0000171033.65639.a9
  6. Porschen R, Bermann A, Loffler T, et al. Fluorouracil plus leucovorin as effective adjuvant chemotherapy in curatively resected stage III colon cancer: results of the trial adjCCA-01. J Clin Oncol 2001;19:1787-1794.
  7. Comparison of flourouracil with additional levamisole, higher-dose folinic acid, or both, as adjuvant chemotherapy for colorectal cancer: a randomised trial: QUASAR Collaborative Group. Lancet 2000;355:1588-1596. https://doi.org/10.1016/S0140-6736(00)02214-5
  8. Sobrero A, Frassineti G, Falcone A, et al. Adjuvant sequential methotrexate $\rightarrow$ 5-fluorouracil vs 5-fluorouracil plus leucovorin in radically resected stage III and high-risk stage II colon cancer. Br J Cancer 2005;92:24-29. https://doi.org/10.1038/sj.bjc.6602276
  9. Chau I, Norman AR, Cunningham D, et al. A randomised comparison between 6 months of bolus fluorouracil/ leucovorin and 12 weeks of protracted venous infusion fluorouracil as adjuvant treatment in colorectal cancer. Ann Oncol 2005;16:549-557. https://doi.org/10.1093/annonc/mdi116
  10. Andre T, Colin P, Louvet C, et al. Semimonthly versus monthly regimen of fluorouracil and leucovorin administered for 24 or 36 weeks as adjuvant therapy in stage II and III colon cancer: results of a randomized trial. J Clin Oncol 2003;21:2896-2903. https://doi.org/10.1200/JCO.2003.10.065
  11. Poplin EA, Benedetti JK, Estes NC, et al. Phase III Southwest Oncology Group 9415/Intergroup 0153 randomized trial of fluorouracil, leucovorin, and levamisole versus fluorouracil continuous infusion and levamisole for adjuvant treatment of stage III and high-risk stage II colon cancer. J Clin Oncol 2005;23:1819-1825. https://doi.org/10.1200/JCO.2005.04.169
  12. Van Cutsem E, Hoff PM, Harper P, et al. Oral capecitabine vs intravenous 5-fluorouracil and leucovorin: integrated efficacy data and novel analyses from two large, randomised, phase III trials. Br J Cancer 2004;90:1190-1197. https://doi.org/10.1038/sj.bjc.6601676
  13. Twelves C, Wong A, Nowacki MP, et al. Capecitabine as adjuvant treatment for stage III colon cancer. N Engl J Med 2005;352:2696-2704. https://doi.org/10.1056/NEJMoa043116
  14. AndreT, Boni C, Mounedji-Boudiaf L, et al. Oxaliplatin, fluorouracil, and leucovorin as adjuvant treatment for colon cancer. N Engl J Med 2004;350:2343-2351. https://doi.org/10.1056/NEJMoa032709
  15. Kuebler JP, Wieand HS, O'Connell MJ, et al. Oxaliplatin combined with weekly bolus fluorouracil and leucovorin as surgical adjuvant chemotherapy for stage II and III colon cancer: results from NSABP C-07. J Clin Oncol 2007;25: 2198-2204. https://doi.org/10.1200/JCO.2006.08.2974
  16. Haller DG, Tabernero J, Maroun J, et al. Capecitabine plus oxaliplatin compared with fluorouracil and folinic acid as adjuvant therapy for stage III colon cancer. J Clin Oncol 2011;29:1465-1471. https://doi.org/10.1200/JCO.2010.33.6297
  17. Schmoll HJ, Tabernero J, Maroun JA, De Braud F. Capecitabine plus oxaliplatin (XELOX) versus bolus 5-fluorouracil/ leucovorin (5-FU/LV) as adjuvant therapy for stage III colon cancer: survival follow-up of study NO 16968 (XELOXA). J Clin Oncol 2012;30(Suppl 4):A388.
  18. AndreT, Boni C, Navarro M, et al. Improved overall survival with oxaliplatin, fluorouracil, and leucovorin as adjuvant treatment in stage II or III colon cancer in the MOSAIC trial. J Clin Oncol 2009;27:3109-3116. https://doi.org/10.1200/JCO.2008.20.6771
  19. Yothers G, O'Connell MJ, Allegra CJ, et al. Oxaliplatin as adjuvant therapy for colon cancer: updated results of NSABP C-07 trial, including survival and subset analyses. J Clin Oncol 2011;29:3768-3774. https://doi.org/10.1200/JCO.2011.36.4539
  20. Van Cutsem E, Labianca R, Bodoky G, et al. Randomized phase III trial comparing biweekly infusional fluorouracil/ leucovorin alone or with irinotecan in the adjuvant treatment of stage III colon cancer: PETACC-3. J Clin Oncol 2009; 27:3117-3125. https://doi.org/10.1200/JCO.2008.21.6663
  21. Saltz LB, Niedzwiecki D, Hollis D, et al. Irinotecan fluorouracil plus leucovorin is not superior to fluorouracil plus leucovorin alone as adjuvant treatment for stage III colon cancer: results of CALGB 89803. J Clin Oncol 2007; 25:3456-3461. https://doi.org/10.1200/JCO.2007.11.2144
  22. Ychou M, Raoul JL, Douillard JY, et al. A phase III randomised trial of LV5FU2 + irinotecan versus LV5FU2 alone in adjuvant high-risk colon cancer (FNCLCC Accord02/ FFCD9802). Ann Oncol 2009;20:674-680. https://doi.org/10.1093/annonc/mdn680
  23. Allegra CJ, Yothers G, O'Connell MJ, et al. Phase III trial assessing bevacizumab in stages II and III carcinoma of the colon: results of NSABP protocol C-08. J Clin Oncol 2011; 29:11-16. https://doi.org/10.1200/JCO.2010.30.0855
  24. de Gramont A, Van Cutsem E, Tabernero J, et al. AVANT: results from a randomized three-arm multinational phase III study to investigate bevacizumab with either XELOX or FOLFOX4 versus FOLFOX4 alone as adjuvant treatment for colon cancer. J Clin Oncol 2011;29(Suppl 4):A362.
  25. Alberts SR, Sargent DJ, Smyrk TC, et al. Adjuvant mFOLFOX6 with or without cetuximab (Cmab) in KRAS wild-type (WT) patients (pts) with resected stage III colon cancer (CC): results from NCCTG Intergroup Phase III Trial N0147. J Clin Oncol 2010;28(18 Suppl):CRA3507.
  26. Sargent DJ, Goldberg RM, Jacobson SD, et al. A pooled analysis of adjuvant chemotherapy for resected colon cancer in elderly patients. N Engl J Med 2001;345:1091-1097. https://doi.org/10.1056/NEJMoa010957
  27. Sundararajan V, Mitra N, Jacobson JS, Grann VR, Heitjan DF, Neugut AI. Survival associated with 5-fluorouracilbased adjuvant chemotherapy among elderly patients with node-positive colon cancer. Ann Intern Med 2002;136: 349-357. https://doi.org/10.7326/0003-4819-136-5-200203050-00007
  28. Sanoff HK, Carpenter WR, Stürmer T, et al. Effect of adjuvant chemotherapy on survival of patients with stage III colon cancer diagnosed after age 75 years. J Clin Oncol 2012;30:2624-2634. https://doi.org/10.1200/JCO.2011.41.1140
  29. Brouquet A, Abdalla EK, Kopetz S, et al. High survival rate after two-stage resection of advanced colorectal liver metastases: response-based selection and complete resection define outcome. J Clin Oncol 2011;29:1083-1090. https://doi.org/10.1200/JCO.2010.32.6132
  30. Nordlinger B, Sorbye H, Glimelius B, et al. Perioperative chemotherapy with FOLFOX4 and surgery versus surgery alone for resectable liver metastases from colorectal cancer (EORTC Intergroup trial 40983): a randomised controlled trial. Lancet 2008;371:1007-1016. https://doi.org/10.1016/S0140-6736(08)60455-9
  31. Rena O, Casadio C, Viano F, et al. Pulmonary resection for metastases from colorectal cancer: factors influencing prognosis: twenty-year experience. Eur J Cardiothorac Surg 2002;21:906-912. https://doi.org/10.1016/S1010-7940(02)00088-X
  32. Haller DG, Catalano PJ, Macdonald JS, et al. Phase III study of fluorouracil, leucovorin, and levamisole in high-risk stage II and III colon cancer: final report of Intergroup 0089. J Clin Oncol 2005;23:8671-8678. https://doi.org/10.1200/JCO.2004.00.5686
  33. Lanza G, Gafà R, Santini A, Maestri I, Guerzoni L, Cavazzini L. Immunohistochemical test for MLH1 and MSH2 expression predicts clinical outcome in stage II and III colorectal cancer patients. J Clin Oncol 2006;24: 2359-2367. https://doi.org/10.1200/JCO.2005.03.2433
  34. Popat S, Hubner R, Houlston RS. Systematic review of microsatellite instability and colorectal cancer prognosis. J Clin Oncol 2005;23:609-618.
  35. Des Guetz G, Lecaille C, Mariani P, et al. Prognostic impact of microsatellite instability in colorectal cancer patients treated with adjuvant FOLFOX. Anticancer Res 2010;30: 4297-4301.
  36. Des Guetz G, Schischmanoff O, Nicolas P, Perret GY, Morere JF, Uzzan B. Does microsatellite instability predict the efficacy of adjuvant chemotherapy in colorectal cancer? a systematic review with meta-analysis. Eur J Cancer 2009;45:1890-1896. https://doi.org/10.1016/j.ejca.2009.04.018
  37. Jover R, Zapater P, Castells A, et al. The efficacy of adjuvant chemotherapy with 5-fluorouracil in colorectal cancer depends on the mismatch repair status. Eur J Cancer 2009;45: 365-373. https://doi.org/10.1016/j.ejca.2008.07.016