Should Oxaliplatin Be Added to 5FU-Based Regimens in Adjuvant Chemotherapy for Locally Advanced Rectal Cancer?

  • Alberto Sobrero
  • Alessandro Pastorino


The question represents an issue of active debate. In fact, on one hand, three options are pursued by oncologists following appropriate locoregional management of locally advanced rectal cancer: no additional adjuvant chemotherapy, fluoropyrimidines alone, and oxaliplatin-based adjuvant chemotherapy. On the other hand, the last version of US National Comprehensive Cancer Network guidelines recommends the use of FOLFOX or XELOX as adjuvant treatment for stage II/III rectal cancer, irrespective of the locoregional treatment delivered [1]. The appropriate definitive answer to the question regarding the role of adjuvant oxaliplatin can be given by a trial that, after optimal locoregional management including completion of preoperative chemoradiotherapy and subsequent TME, randomizes patients with pathological stage II/III rectal cancer, therefore pathologically staged, to receive adjuvant FOLFOX/XELOX versus fluorouracil/capecitabine alone. Actually, this trial exists. It is the Korean phase II randomized ADORE trial, recently published [2]. However, in order to adequately answer such an important question, at least one appropriately powered phase III trial is needed, not just a phase II as the Korean study. Because other phase III trials with similar (not identical) designs exist, we will consider the results of these trials as well.


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© Springer-Verlag Berlin Heidelberg 2018

Authors and Affiliations

  1. 1.IRCCS San Martino ISTGenoaItaly

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