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ASCO Guidelines for Stage 2 Colon Cancer Do Not Recommend Routine Use of Adjuvant Chemotherapy

ASCO’s most recent Clinical Practice Guideline addressed the use of adjuvant chemotherapy for the treatment of patients with curatively resected stage II colon cancer. The recommendations included in the guideline were developed in collaboration with Cancer Center Ontario and published in the Journal of Clinical Oncology.

On the basis of the meta-analysis described in the guideline, ASCO does not recommend the routine use of adjuvant chemotherapy for medically fit, average-risk patients with stage II colon cancer. Clinical trials have not established a significant clinical benefit for adjuvant chemotherapy for these patients, although most trials do show a small increase in survival outcome for patients who receive adjuvant chemotherapy five years after surgery, compared with patients who receive only surgery.

ASCO encourages oncologists to discuss clinical trials options with their patients, and the “Discussion Points” section of the guideline offers practical tips on how to approach this topic. “Patients and their families often want black-and-white guidance on how to treat their disease,” says Al B. Benson III, MD, FACP, Director of the Robert H. Lurie Comprehensive Cancer Center’s Clinical Investigations Program at Northwestern University and lead contributor to the guideline. “Unfortunately, that is not possible with stage II colon cancer. It is critical for each patient to weigh the risk of therapy and any potential benefit. The ASCO Discussion Points provide an opportunity for patients and physicians to discuss what is known about stage II colon cancer. By reviewing these points, we feel that patients will be better able to make informed decisions.”

ASCO also released the patient guide, Adjuvant Chemotherapy for Stage II Colon Cancer, a patient-friendly version of the Clinical Practice Guideline. The Society’s patient guide series is designed as a tool to enhance patient-physician communication and enable patients to better participate in decision-making regarding treatment options.

Source: American Society of Clinical Oncology

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