[Adjuvant systemic chemo- or immunotherapy of colon cancer]

The recurrence-free and overall survival of patients with colon carcinoma in UICC stage III can be improved under a postoperative chemotherapy with 5-fluorouracil combined with the unspecific immune-modulator levamisole. The pharmacological interaction of both components is however disputed. The point is whether the therapeutic effect is achieved only through a high dose monotherapy with 5-FU or whether it can also be achieved by the specific modulation of the 5-FU with folinic acid. Possibly the prognosis for a subgroup of patients in stage II (Dukes B2) could be improved with this combination of drugs. Additionally, there are clinical experiences that the postoperative tumor cell vaccination (ASI) or the treatment with monoclonal antibodies against tumor-associated antigens (CA17-1A) might reveal more specific possibilities in immunotherapy than are provided with levamisole so far. An answer to these questions can therefore only be given by well designed and performed prospective trials.