Adjuvant chemotherapy of colon cancer current strategies

Adjuvant chemotherapy has become a standard of care in patients with early stage colon cancer. 5-Fluorouracil modulated by leucovorin is the mainstay of treatment, but it has evolved from the bolus administration to continuous infusion and combination therapy. Oral fluoropyrimidines may be an alternative to bolus 5-fluorouracil plus folinic acid. The benefit of adjuvant therapy is established in stage III colon cancer, whereas in stage II the evidence supporting the adjuvant therapy is still poor. Current issues concern the duration of treatment, the development of new schedules and strategies including biological agents and the identification of prognostic and predictive biological markers.