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Based on results of the IDEA trial (NEJM JW Oncol Hematol May 2018 and N Engl J Med 2018; 378:1177), the standard of care for patients with low-risk (N1) stage III colon cancer is 3 months of adjuvant capecitabine and oxaliplatin (CAPOX). For stage II disease, even in the high-risk setting (T4 or high-risk T3), adjuvant therapy appears to have limited benefit, and the contribution of oxaliplatin added to a fluorinated pyrimidine is also questionable.
Investigators in Italy now report results from the multicenter, open-label, noninferiority phase III TOSCA trial (a subgroup study of the IDEA trial), which evaluated 3 versus 6 months of adjuvant chemotherapy in 1254 patients with high-risk stage II resected colorectal cancer. Among these patie…