Future directions in adjuvant therapy for stage III colon carcinoma

The current recommendation for adjuvant chemotherapy for patients with newl y diagnosed stage III colon cancer involves 6 months of fluorouracil(5-FU)p lus low- or high-dose leucovorin. In clinical trials performed throughout t he world, several drugs have demonstrated either improved toxicity profiles or antitumor activity for patients with advanced colorectal carcinoma. Ura cil and tegafur (UFT) and capecitabine (Xeloda) are two examples of new ora l chemotherapy compounds with acceptable side-effect profiles irt early adj uvant or advanced disease trials. Irinotecan (CPT-II, Camptosar) and oxalip latin, when administered intravenously in combination with a 5-FU regimen, have both demonstrated significant antitumor effects for patients with adva nced-stage disease. Other immunotherapies, including monoclonal antibodies and cancer vaccines, are being evaluated to help stimulate immune responses irt patients with resected colon cancer. These agents are just a few examp les of the new compounds being tested in the next generation of clinical tr ials for resected stage III colon cancer. Future and ongoing investigations will look to integrate these new therapies as we attempt to move beyond th e era of 5-FU and leucovorin.