Adjuvant therapy for colorectal cancer: Past accomplishments, future directions

This review has briefly examined the past accomplishments in the adjuvant treatment of patients with cancers of the colon and rectum. Validation of new prognostic markers to further define which patients are at highest risk of recurrence will be important. Future directions for adjuvant therapy include incorporation of achievements made in the advanced disease setting including biochemical modulation of 5-FU, identification of new active agents, and incorporation of immunotherapy approaches into adjuvant treatment programs. Further improvements in the treatment of these patients, even if incremental compared to standard therapy, may translate into clinically important gains given the large number of patients presenting each year with these tumors. As the therapeutic armamentarium improves for the adjuvant treatment of colorectal cancer, investigators will need to focus on quality of life and pharmacoeconomic parameters to determine which are the optimal adjuvant approaches for the individual patient as well as for society as a whole.