[Adjuvant chemotherapy for colorectal cancer]

Area of Science:

• Oncology
• Pharmacology

Background:

• The efficacy of 5-fluorouracil (5-FU) plus leucovorin (LV) as adjuvant chemotherapy for colorectal cancer is well-established in Western countries.
• Recent large multicenter trials have evaluated new regimens, including oxaliplatin+5-FU+LV, capecitabine, and uracil-tegafur (UFT)+LV, against the standard 5-FU+LV.

Purpose of the Study:

• To review the evolving landscape of adjuvant chemotherapy for colorectal cancer, with a focus on evidence emerging from Japan.
• To highlight the increasing efficacy of oral 5-FU prodrugs and regimens in colorectal cancer treatment.

Main Methods:

• Review of recent large multicenter randomized controlled trials comparing novel chemotherapy regimens with 5-FU+LV.
• Analysis of trial and meta-analysis data on oral regimens including UFT and carmofur in Japan.

Main Results:

• Newer regimens are establishing new standards for adjuvant chemotherapy in colorectal cancer.
• Evidence from Japan indicates the efficacy of oral regimens, such as UFT+LV and carmofur, in colorectal cancer treatment.
• Further integration of targeted therapies like cetuximab and bevacizumab may be promising but presents cost considerations.

Conclusions:

• Japan is contributing significant evidence for the efficacy of oral-based adjuvant chemotherapy regimens for colorectal cancer.
• The therapeutic landscape for colorectal cancer is shifting towards new standards, including oral agents.
• Future directions may involve targeted therapies, balanced against economic factors.