The latest SEOM-GEMCAD-TTD clinical guidelines offer comprehensive updates on the adjuvant treatment of colon cancer, emphasizing the importance of personalized therapeutic strategies to optimize patient outcomes. These guidelines provide evidence-based recommendations tailored to tumor stage, molecular characteristics, and patient-specific factors, highlighting the shift towards precision medicine in oncology.
For stage II colon cancer, adjuvant chemotherapy (ACT) is not routinely recommended but may be considered in high-risk cases, such as those with T4 tumors. In stage III disease, the combination of fluoropyrimidines with oxaliplatin remains the standard of care, with the duration of therapy adapted to individual patient risk profiles. The guidelines also explore emerging approaches, including the role of immunotherapy in microsatellite instability-high (MSI-H) tumors within neoadjuvant settings and the use of circulating tumor DNA (ctDNA) as a predictive tool for relapse, which may guide treatment decisions more effectively in the future.
Special attention is given to elderly patients, with recommendations for tailored ACT regimens that balance efficacy and tolerability, recognizing the unique challenges faced by this population. The guidelines underscore the importance of multidisciplinary team involvement in treatment planning to ensure comprehensive, patient-centered care.
