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A panel discussion of controversies and challenges in the adjuvant treatment of colon cancer

Discusión de expertos sobre controversias y retos en el tratamiento adyuvante del

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Abstract

Current issues of adjuvant therapy for colon cancer concern the introduction of drugs other than fluorouracil-5/leucovorin (5-FU/LV), the benefits for stage II patients, the use of new primary endpoints and the influence of age on treatment benefits. These issues were addressed in a panel discussion and the conclusions were the following: FOLFOX4 is the first regimen that shows superiority over 5-FU/LV. The use of 3-year disease-free survival as primary endoint could encourage the quicker adoption of improved therapeutic strategies into clinical practice. Available data suggest that there are some benefits for stage II patients, and the decision needs to be individualised for each patient. Further, therapeutic decisions based solely on the patient's age are inappropriate, and geriatric assessment tools will help in making this decision. This information would improve patient and physician understanding of the recent data regarding the potential benefits of adjuvant therapy.

Resumen

Las controversias actuales referentes al tratamiento adyuvante del cáncer de colon incluyen la introducción de fármacos más allá de 5-FU/LV, el beneficio que ofrece a los pacientes con estadio II, el uso de nuevas variables y la influencia de la edad sobre los beneficios del tratamiento. Estas controversias fueron discutidas en un panel de expertos y las conclusiones fueron las siguientes: FOLFOX4 es el primer régimen que ha demostrado superioridad frente a 5-FU/LV. El uso de la supervivencia libre de enfermedad a 3 años como variable principal de los estudios podrá permitir una adopción más répida de estrategias terapéuticas. Los datos disponibles sugieren que existe beneficio para los pacientes con estadio II, y la decisión terapéutica debe ser individualizada. Finalmente, también se llegó a la conclusión de que las decisiones basadas únicamente en la edad no son apropiadas, y las herramientas de valoración geriátrica servirán de apoyo. Esta información puede mejorar el entendimiento de pacientes y médicos acerca de los datos recientes relativos a los beneficios del tratamiento adyuvante.

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Authors and Affiliations

  1. Service of Medical Oncology, Hospital Universitario San Carlos, Madrid, Spain

    Eduardo Díaz-Rubio García

  2. Service of Medical Oncology, Hospital Universitari Germans Trias i Pujol. Badalona, Barcelona, Spain

    Albert Abad Esteve

  3. Service of Medical Oncology, Hospital Miguel Servet, Zaragoza, Spain

    Antonio Antón Torres

  4. Service of Medical Oncology, Hospital Reina Sofia, Córdoba, Spain

    Enrique Aranda Aguilar

  5. Service of Medical Oncology, Hospital General Carlos Haya, Málaga, Spain

    Manuel Benavides Orgaz

  6. Service of Medical Oncology, Hospital General Universitario de Elche, Elche. Alicante, Spain

    Alfredo Carrato Mena

  7. Service of Medical Oncology, Hospital Clínico Universitario, Valencia, Spain

    Andrés Cervantes Ruipérez

  8. Service of Medical Oncology, Ciudad Sanitaria La Paz, Madrid, Spain

    Jaime Feliu Batle

  9. Service of Medical Oncology, Hospital General Universitario Gregorio Marañón, Madrid, Spain

    Pilar García Alfonso

  10. Laboratory of Biotechnology and Pharmacogenomics, Clínica Universitaria de Navarra, Pamplona, Spain

    Jesús García Foncillas

  11. Service of Medical Oncology, Hospital Universitario 12 de Octubre, Madrid, Spain

    Cristina Garávalos Castro

  12. Service of Medical Oncology. Institut Català d'Oncologia (ICO), L'Hospitalet de Llobregat, Barcelona, Spain

    Matilde Navarro García

  13. Service of Medical Oncology, Hospital Universitario Marqués de Valdecilla, Santander, Spain

    Fernando Rivera Herrero

  14. Service of Medical Oncology, Hospital General Vall d'Hebron, Barcelona, Spain

    José María Tabernero Caturla

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  1. Eduardo Díaz-Rubio García
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Correspondence to Eduardo Díaz-Rubio García.

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García, E.DR., Esteve, A.A., Torres, A.A. et al. A panel discussion of controversies and challenges in the adjuvant treatment of colon cancer. Clin Transl Oncol 7, 3–11 (2005). https://doi.org/10.1007/BF02710019

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