NCCN Guidelines for Patients® | Colon Cancer - page 66

NCCN Guidelines for Patients™: Colon Cancer
Version 1.2012
Part 7: A step-by-step treatment guide
7.7 Systemic therapy for advanced
Systemic therapy for advanced colon cancer is given in
many situations. When surgery is not possible, systemic
therapy is an option. Systemic therapy is also given before
surgery to shrink tumors and afterwards to treat any
remaining cancer cells.
There are many chemotherapy choices for advanced
colon cancer. Your doctor may start you on an intensive
chemotherapy regimen. There are four groups of
chemotherapy options for first-line treatment. The
first group is oxaliplatin-based regimens, such as
FOLFOX or CapeOX. See Table 7 for the drug names
of the chemotherapy regimens.The second group is
irinotecan-based regimens, such as FOLFIRI. The third
group excludes both oxaliplatin and irinotecan, such as
capecitabine. The fourth group includes one chemotherapy
regimen of FOLFOXIRI. Targeted therapy is sometimes
used with chemotherapy for advanced disease. See
Principles of systemic therapy
on page 58 for more
information. If your cancer grows, there are options for
second- and third-line treatments based on your initial
chemotherapy group.
Some people have severe side effects to the intensive
regimens. You may better tolerate infusional 5-FU/
LV or other options. If your cancer doesn’t respond to
chemotherapy that isn’t considered intensive, you may
want to receive supportive care for any symptoms you are
having. If your cancer does respond for a period of time
but then starts to grow again, consider taking intensive
Table 7. Chemotherapy regimen drugs for
advanced disease
Drug names
5-FU = fluorouracil
LV = leucovorin calcium
Cape = capecitabine
OX = oxaliplatin
FOL = leucovorin
F = fluorouracil
IRI = Irinotecan
FOL = leucovorin
F = fluorouracil
OX = oxaliplatin
FOL = leucovorin
F = fluorouracil
OX = oxaliplatin
IRI = Irinotecan
IR = Irinotecan
OX = Oxaliplatin
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