The Role of Neoadjuvant Chemotherapy in Locally Advanced Colon Cancer

• Main Authors: Body A, Prenen H, Latham S, Lam M, Tipping-Smith S, Raghunath A, Segelov E
• Format: Article
• Language: English
• Published: Dove Medical Press 2021-03-01
• Series: Cancer Management and Research
• Subjects: colorectal cancer; preoperative chemotherapy; perioperative chemotherapy; staging
• Online Access: https://www.dovepress.com/the-role-of-neoadjuvant-chemotherapy-in-locally-advanced-colon-cancer-peer-reviewed-article-CMAR

Amy Body,1,2 Hans Prenen,1,3 Sarah Latham,1 Marissa Lam,1 Samuel Tipping-Smith,1 Ajay Raghunath,1 Eva Segelov1,2 1Medical Oncology, Monash Medical Centre, Clayton, Melbourne, VIC, Australia; 2School of Clinical Sciences, Monash University, Clayton, Melbourne, VIC, Australia; 3Oncology Department, University Hospital Antwerp, Antwerp, BelgiumCorrespondence: Amy BodyMonash Health Translational Precinct, Monash Medical Centre, 246 Clayton Road, Clayton, Melbourne, VIC 3168, AustraliaEmail [e-mail]: Neoadjuvant systemic therapy has many potential advantages over up-front surgery, including tumor downstaging, early treatment of micrometastatic disease, and providing an in vivo test of tumor biology. Due to these advantages, neoadjuvant therapy is becoming the standard of care for an increasing number of tumor types. Currently, colon cancer patients are still routinely treated with up-front surgery, and neoadjuvant systemic therapy is not yet standard. Limitations to widespread use of neoadjuvant therapy have included inaccurate radiological staging, concerns about tumor progression while undergoing preoperative treatment rendering a patient incurable, and a lack of randomized data demonstrating benefit. However, there is great interest in neoadjuvant chemotherapy, and a number of trials are under way. Early follow up of the first phase III trial of neoadjuvant chemotherapy for colon cancer demonstrated tumor downstaging and suggested an improvement in disease-free survival with neoadjuvant chemotherapy, and it is hoped that this will translate into longer-term overall survival benefit. Clinicians should closely watch this developing field, consider the option of neoadjuvant chemotherapy for colon cancer patients, and actively seek out opportunities for their patients to participate in ongoing clinical trials to further inform this field in future.Keywords: colorectal cancer, preoperative chemotherapy, perioperative chemotherapy, staging