Dr. Shields Discusses Patient Selection Criteria for Adjuvant Therapy in CRC

Anthony Shields, MD, PhD, oncologist, Department of Oncology, Molecular Imaging and Diagnostics Program, Karmanos Cancer Institute, discusses patient selection criteria for adjuvant therapy in colorectal cancer (CRC).

Patients who are eligible for adjuvant therapy have an increased risk of recurrence, specifically patients with high-risk stage II disease or moderate- to high-risk patients with stage III disease. However, patients with small stage III tumors or limited lymph node involvement may not need adjuvant therapy, says Shields.

A patient’s risk status should be a major determinant in the optimal adjuvant therapy. Additionally, the added benefit of 3 versus 6 months of therapy and the specific regimens involved—namely, CAPOX or FOLFOX. Patient preference is another important factor, says Shields. In the community setting, some patients may only be given the chance to receive 6 months of FOLFOX, whereas evidence suggests 3 months of CAPOX may be superior. Moreover, CAPOX does not require a pump to be administered. However, Shields cautions that patients have to be compliant as physicians are reliant on patients to take the capecitabine pills at home.