Taieb Julien, Gallois Claire
Sorbonne Paris cite, University of Paris, 75006 Paris, France.
Siric CARPEM, Assistance Publique-Hôpitaux de Paris, Department of Gastroenterology and Digestive Oncology, Hôpital Européen Georges Pompidou, 75015 Paris, France.
Cancers (Basel). 2020 Sep 19;12(9):2679. doi: 10.3390/cancers12092679.
In patients with stage III colon cancer (CC), adjuvant chemotherapy with the combination of oxapliplatin to a fluoropyrimidine (FOLFOX or CAPOX) is a standard of care. The duration of treatment can be reduced from 6 months to 3 months, depending on the regimen, for patients at low risk of recurrence, without loss of effectiveness and allowing a significant reduction in the risk of cumulative sensitive neuropathy. However, our capacity to identify patients that do really need this doublet adjuvant treatment remains limited. In fact, only 30% at the most will actually benefit from this adjuvant treatment, 50% of them being already cured by the surgery and 20% of them experiencing disease recurrence despite the adjuvant treatment. Thus, it is necessary to be able to better predict individually for each patient the risk of recurrence and the need for adjuvant chemotherapy together with the need of new treatment approaches for specific subgroups. Many biomarkers have been described with their own prognostic weight, without leading to any change in clinical practices for now. In this review, we will first discuss the recommendations for adjuvant chemotherapy, and then the different biomarkers described and the future perspectives for the management of stage III CC.
对于III期结肠癌（CC）患者，奥沙利铂联合氟嘧啶（FOLFOX或CAPOX）进行辅助化疗是标准治疗方案。根据治疗方案，对于复发风险较低的患者，治疗时长可从6个月减至3个月，且不影响疗效，同时能显著降低累积性感觉神经病变的风险。然而，我们识别真正需要这种双联辅助治疗患者的能力仍然有限。事实上，最多只有30%的患者会真正从这种辅助治疗中获益，其中50%已通过手术治愈，20%尽管接受了辅助治疗仍出现疾病复发。因此，有必要能够更好地针对每位患者个体预测复发风险、辅助化疗的必要性以及特定亚组对新治疗方法的需求。已经描述了许多具有各自预后权重的生物标志物，但目前尚未导致临床实践发生任何改变。在本综述中，我们将首先讨论辅助化疗的建议，然后探讨所描述的不同生物标志物以及III期CC管理的未来前景。
