Updates in adjuvant systemic therapy for colon cancer research focuses on identifying patients who will most benefit and on minimizing long-term side effects

Rachel Goodwin, MD, MSc, FRCPC is an Investigational New Drug Development Fellow at The Ottawa Hospital Cancer Centre, Ottawa, ON. Nirit Yarom, MD is a medical Oncology Clinical Fellow at The Ottawa Hospital Cancer Centre. Jean Maroun, MD, FRCPC, FRCP (London) is a medical Oncologist at the Ottawa Hospital Cancer Centre, and Professor at the University of Ottawa. AbStRACt Colon cancer is common in Canada and leads to significant morbidity, mortality, and social and economic impact. In 2010, the estimated incidence of colorectal cancer in Canada was 22,500 cases, with 9100 deaths. In early-stage colon cancer, surgery remains the primary curative procedure. However, due to increased risk of recurrence, adjuvant treatment is now a well-established standard of care. Adjuvant treatment has become more complex with the addition of new chemotherapy regimens that have proven active against this disease. As well, molecular prognostic and predictive tools have emerged to better tailor therapy to higher-risk populations. This overview summarizes changes in adjuvant treatment of colon cancer over the past decade, including: modification of the TNM classification system; the role of adjuvant systemic treatment in Stages II and III colon cancer; issues surrounding treatment in the elderly; and optimal timing of chemotherapy following surgery. Adjuvant systemic treatment of colon cancer continues to be an area of active research, with a focus on identifying patients who will benefit most from chemotherapy and minimizing the long-term side effects.