Dr. Choti on Updates in Neoadjuvant and Adjuvant Therapy for CRC

Michael A. Choti, MD, chief of surgery, Banner MD Anderson Cancer Center, discusses updates in neoadjuvant and adjuvant therapy for patients with colorectal cancer (CRC).

Choti says that the role of neoadjuvant and adjuvant therapy has been changing in CRC, particularly in rectal cancer. Most patients with rectal cancer receive neoadjuvant chemotherapy and radiation, and then adjuvant chemotherapy following surgery. Now, there is an increasing trend to move chemotherapy prior to neoadjuvant chemoradiation, Choti says.

In colon cancer, there have been changes regarding postoperative adjuvant therapy. Typically, patients receive surgery first, and then postoperative chemotherapy is offered to some patients, usually those with stage III disease, notes Choti. New studies have shown that the duration of chemotherapy can be reduced from the usual 6 months to 3 months in some cases. Choti says that the advantage of this shorter schedule, particularly with oxaliplatin-based regimens, is a reduction in adverse events such as neurotoxicity. It cannot be said that 3 months is appropriate for all patients.