Dr. Venook Discusses Adjuvant Chemotherapy Duration in CRC

Alan P. Venook, MD, The Madden Family Distinguished Professor of Medical Oncology and Translational Research at the University of California, San Francisco Helen Diller Family Comprehensive Cancer Center, discusses adjuvant chemotherapy duration in colon cancer.

The challenge in the management of colon cancer is the inability to advance beyond the current standard of care, 5-fluorouracil (5-FU), leucovorin, and oxaliplatin (FOLFOX), which has shown curative benefits in the adjuvant setting. The problem with FOLFOX is that it causes peripheral neuropathy in almost all patients treated with the regimen, says Venook. The average onset of neuropathy with this regimen is between 7 and 8 doses, and the goal is to reach 12 cycles.

The goal of the IDEA trial, an international collaboration, was to answer the question of whether less chemotherapy would reduce the risk of neuropathy without sacrificing efficacy. The analysis involved more than 12,800 patients with low-risk advanced colon cancer, and results showed that most patients in this population would benefit from a 50% reduction in the oxaliplatin-containing chemotherapy that they typically receive after surgery, decreasing the likelihood of neuropathy and without significantly increasing their risk of recurrence.