Adjuvant Chemotherapy for Colorectal Cancer in the Era of Genomic Medicine

Miyoshi Norikatsu, Fujino Shiki, Sekido Yuki, Hata Tsuyoshi, Hamabe Atsushi, Ogino Takayuki, Takahashi Hidekazu, Uemura Mamoru, Yamamoto Hirofuim, Doki Yuichiro, Eguchi Hidetoshi

doi:10.3862/jcoloproctology.75.468

<p>For postoperative stage III colorectal cancer, 6-month oxaliplatin combination therapy has been shown to reduce the risk of recurrence and death compared to 5-FU + l-LV, and is recommended as the most effective treatment option. Although non-inferiority of the 3-month treatment group to the 6-month treatment group was not shown, subgroup analysis showed superior disease-free survival in the 6-month treatment group in the FOLFOX group and non-inferiority of 3-month treatment in the CAPOX group. As for the side effects of neuropathy, it is important to consider the balance with the therapeutic effect because it is less in the 3-month administration group. In recent years, liquid biopsy has been used to evaluate the risk of recurrence by evaluating gene expression associated with cancer cells in tissue specimens by combining gene mutation analysis of BRAF, KRAS, and PIK3CA and the status of MSI. There is also widespread research to evaluate cell-free/circulating-tumor DNA. When selecting treatments, there is a problem of toxicity of long-term administration, so treatment should take into account the risk of recurrence, effects and balance.</p>

Adjuvant Chemotherapy for Colorectal Cancer in the Era of Genomic Medicine

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