Managing Adjuvant Treatment in Colorectal Cancer, Part I

Panelists: Johanna Bendell, MD, Sarah Cannon; Axel Grothey, MD, Mayo Clinic; Claus-Henning Köhne, MD, PhD, Klinikum Oldenburg; John L. Marshall, MD, Georgetown-Lombardi;
Heinz-Josef Lenz, MD, USC Norris
Published Online: Tuesday, April 2, 2013
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Moderator, John L. Marshall, MD, introduces the panel for a unique discussion on advances and challenges in the management of colorectal cancer (CRC). Overall, the discussion will describe new therapies, treatment paradigms, and molecular targets with expert perspectives from Johanna Bendell, MD, Axel Grothey, MD, Claus-Henning Kohne, MD, PhD, and Heinz-Josef Lenz, MD.

Kohne begins the conversation by describing adjuvant treatment in stage II and III CRC, which, he believes, represents a major advance in treatment. For patients with stage III CRC, the number of lymph nodes involved helps gauge risk and the aggressiveness of treatment. However, he adds, most patients with stage III node positive CRC will receive adjuvant treatment with FOLFOX, regardless of the number of nodes involved. Elderly patients may require more precaution before treatment with FOLFOX or the administration of a different agent, such as capecitabine or oral fluoropyrimidines.

All patients with positive lymph nodes and stage III CRC should receive adjuvant therapy, Bendell believes. In general, the prime treatment should be FOLFOX or capecitabine and oxaliplatin. In the stage II setting, Bendell notes that patients with node negative CRC with large T3 or T4 tumors may have the same risk of recurrence as patients with stage III T2N1 tumor. In this situation, debate exists regarding the aggressiveness of adjuvant treatment.

View >>> Managing Adjuvant Treatment in Colorectal Cancer, Part II
View More From This Discussion
Episode 1 Managing Adjuvant Treatment in Colorectal Cancer, Part I
Episode 2 Managing Adjuvant Treatment in Colorectal Cancer, Part II
Episode 3 Understanding the Role of Aspirin in Colorectal Cancer
Episode 4 Exploring the Neoadjuvant Treatment of Rectal Cancer
Episode 5 Treating Resectable Metastatic Colorectal Cancer
Episode 6 Treating Unresectable Metastatic Colorectal Cancer
Episode 7 Treatment Sequencing in Metastatic Colorectal Cancer
Episode 8 Determining Optimal Treatments in mCRC
Episode 9 Second-Line Therapies for Patients With mCRC
Episode 10 Case Study: Treating Metastatic Colorectal Cancer
Episode 11 Conclusion: Optimal Side Effect Management in CRC
Expert Panelists
Dr. John L. Marshall

John L. Marshall, MD

Professor, Chief, Division of Hematology/Oncology,
Georgetown University Hospital,
Associate Director, Clinical Research,
Lombardi Comprehensive Cancer Center,

Johanna Bendell, MD

Director, GI Oncology Research
Associate Director, Drug Development Unit
Sarah Cannon Research Institute
Nashville, TN

Axel Grothey, MD

Professor of Oncology and Consultant
Division of Medical Oncology
Department of Oncology, Mayo Clinic
Rochester, MN

Claus-Henning Köhne, MD, PhD

Professor of Medicine,
Department of Oncology/Hematology
Klinikum Oldenburg
Oldenburg, Germany

Heinz-Josef Lenz, MD

Co-Director, Colorectal Center and GI Oncology Program, USC Norris Comprehensive Cancer Center, Los Angeles, CA
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