Subscribe to RSS
![](/products/assets/desktop/img/oa-logo.png)
DOI: 10.4103/ijmpo.ijmpo_149_20
Colorectal Cancer Chemotherapy during COVID-19 Pandemic
Financial support and sponsorship Nil.![](https://www.thieme-connect.de/media/10.1055-s-00050348/202002/lookinside/thumbnails/10-4103-ijmpo-ijmpo_149_20_156-1.jpg)
Abstract
The management of patients with colorectal cancer during the current SARS-CoV2 pandemic opens a Pandora's Box. While the world is facing an unprecedented crisis of fighting a life-threatening infectious disease, patients with colorectal cancer are facing the dual challenge to fight cancer while protecting them from infection. We attempted to critically examine the existing evidence for chemotherapy in colorectal cancer in different stages of disease and suggest treatment options in these vulnerable patients. Treatment options which do not overburden existing health-care resources can be provided for patients with colorectal cancer patients requiring chemotherapy without significant compromise in efficacy or increase the risk of hospital acquired SAR-CoV-2 infection.
Publication History
Received: 09 April 2020
Accepted: 19 April 2020
Article published online:
23 May 2021
© 2020. Indian Society of Medical and Paediatric Oncology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/.)
Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India
-
References
- 1 Global Cancer Statistics 2018: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. https://acsjournals.onlinelibrary.wiley.com/doi/epdf/10.3322/caac Available from: 21492. [Last accessed on 2020 Apr 05]
- 2 Liang W, Guan W, Chen R, Wang W, Li J, Xu K. et al. Cancer patients in SARS-CoV-2 infection: A nationwide analysis in China. Lancet Oncol 2020; 21: 335-7
- 3 Guan W, Liang W, Zhao Y, Liang H, Chen Z, Li Y. et al. Comorbidity and its impact on 1590 patients with Covid-19 in China: A nationwide analysis. Eur Respir J 2020; pii: 2000547
- 4 Onder G, Rezza G, Brusaferro S. Case-fatality rate and characteristics of patients dying in relation to COVID-19 in Italy. JAMA. 2020. https://jamanetwork.com/journals/jama/fullarticle/2763667. Published online March 23, 2020. Available from [Last accessed on 2020 Apr 09]
- 5 André T, Boni C, Navarro M, Tabernero J, Hickish T, Topham C. et al. Improved overall survival with oxaliplatin, fluorouracil, and leucovorin as adjuvant treatment in stage II or III colon cancer in the MOSAIC trial. J Clin Oncol 2009; 27: 3109-16
- 6 Weiser MR. AJCC 8th edition: Colorectal cancer. Ann Surg Oncol 2018; 25: 1454-5
- 7 Sargent DJ, Marsoni S, Monges G, Thibodeau SN, Labianca R, Hamilton SR. Defective mismatch repair as a predictive marker for lack of efficacy of fluorouracil-based adjuvant therapy in colon cancer. J Clin Oncol 2010; 28: 3219-26
- 8 Prospective pooled analysis of four randomized trials investigating duration of adjuvant (adj) oxaliplatin-based therapy (3 vs. 6 months {m}) for patients (pts) with high-risk stage II colorectal cancer (CC). J Clin Oncol 2019; 37: 3501 https://ascopubs.org/doi/abs/10.1200/JCO.2019.37.15_suppl 15_suppl Available from: 3501. [Last accessed on 2020 Apr 05]
- 9 Boyne DJ, Cuthbert CA, O'Sullivan DE, Sajobi TT, Hilsden RJ, Friedenreich CM. et al. Association between adjuvant chemotherapy duration and survival among patients with stage II and III colon cancer. JAMA Netw Open 2019; 2: e194154
- 10 Grothey A, Sobrero AF, Shields AF, Yoshino T, Paul J, Taieb J. et al. Duration of adjuvant chemotherapy for stage III colon cancer. N Engl J Med 2018; 378: 1177-88
- 11 Peng J, Li W, Zhang R, Lin J, Tang J, Wen Y. et al. Safety and efficacy of a modified XELOX adjuvant regimen for patients with operated stage III colon cancer: A Chinese single-center experience. Cancer Commun (Lond) 2019; 39: 59
- 12 Shah MA, Renfro LA, Allegra CJ, André T, de Gramont A, Schmoll HJ. et al. Impact of patient factors on recurrence risk and time dependency of oxaliplatin benefit in patients with colon cancer: Analysis from modern-era adjuvant studies in the adjuvant colon cancer end points (ACCENT) database. J Clin Oncol 2016; 34: 843-53
- 13 Lieu C, Kennedy EB, Bergsland E, Berlin J, George TJ, Gill S. et al. Duration of oxaliplatin-containing adjuvant therapy for stage III colon cancer: ASCO clinical practice guideline. J Clin Oncol 2019; 37: 1436-47
- 14 Polanco PM, Mokdad AA, Zhu H, Choti MA, Huerta S. Association of adjuvant chemotherapy with overall survival in patients with rectal cancer and pathologic complete response following neoadjuvant chemotherapy and resection. JAMA Oncol 2018; 4: 938-43
- 15 Maas M, Nelemans PJ, Valentini V, Crane CH, Capirci C, Rödel C. et al. Adjuvant chemotherapy in rectal cancer: Defining subgroups who may benefit after neoadjuvant chemoradiation and resection: A pooled analysis of 3,313 patients. Int J Cancer 2015; 137: 212-20
- 16 Oxaliplatin/Fluorouracil-Based Adjuvant Chemotherapy for Locally Advanced Rectal Cancer after Neoadjuvant Chemoradiotherapy and Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled Trials-Zhao-2016-Colorectal Disease-Wiley Online Library. https://onlinelibrary.wiley.com/doi/epdf/10.1111/codi.13381 Available from: [Last accessed on 2020 Apr 05]
- 17 Valentini V, van Stiphout RG, Lammering G, Gambacorta MA, Barba MC, Bebenek M. et al. Nomograms for predicting local recurrence, distant metastases, and overall survival for patients with locally advanced rectal cancer on the basis of European randomized clinical trials. J Clin Oncol 2011; 29: 3163-72
- 18 FOxTROT: An international randomised controlled trial in 1052 patients (pts) evaluating neoadjuvant chemotherapy (NAC) for colon cancer. J Clin Onco. 2019 37. 3504 https://ascopubs.org/doi/abs/10.1200/JCO2019.37.15_suppl.3504 15 Suppl Available from: [Last accessed on 2020 Apr 05]
- 19 Xu RH, Muro K, Morita S, Iwasa S, Han SW, Wang W. et al. Modified XELIRI (capecitabine plus irinotecan) versus FOLFIRI (leucovorin, fluorouracil, and irinotecan), both either with or without bevacizumab, as second-line therapy for metastatic colorectal cancer (AXEPT): A multicentre, open-label, randomised, non-inferiority, phase 3 trial. Lancet Oncol 2018; 19: 660-71
- 20 Shigeta K, Hasegawa H, Okabayashi K, Tsuruta M, Ishii Y, Endo T. et al. Randomized phase II trial of TEGAFIRI (tegafur/uracil, oral leucovorin, irinotecan) compared with FOLFIRI (folinic acid, 5-fluorouracil, irinotecan) in patients with unresectable/recurrent colorectal cancer. Int J Cancer 2016; 139: 946-54
- 21 Bennouna J, Saunders M, Douillard JY. The role of UFT in metastatic colorectal cancer. Oncology 2009; 76: 301-10
- 22 Bajetta E, Di Bartolomeo M, Buzzoni R, Mariani L, Zilembo N, Ferrario E. et al. Uracil/ftorafur/leucovorin combined with irinotecan (TEGAFIRI) or oxaliplatin (tegafox) as first-line treatment for metastatic colorectal cancer patients: Results of randomised phase II study. Br J Cancer 2007; 96: 439-44
- 23 Douillard JY, Zemelka T, Fountzilas G, Barone C, Schlichting M, Heighway J. et al. FOLFOX4 with cetuximab vs. UFOX with cetuximab as first-line therapy in metastatic colorectal cancer: The randomized phase II FUTURE study. Clin Colorectal Cancer 2014; 13: 14-26.e1
- 24 Sheikh HY, Valle JW, Waddell T, Palmer K, Wilson G, Sjursen A. Alternating irinotecan with oxaliplatin combined with UFT plus leucovorin (SCOUT) in metastatic colorectal cancer. Br J Cancer 2008; 99: 577-83
- 25 Sonbol MB, Mountjoy LJ, Firwana B, Liu AJ, Almader-Douglas D, Mody K. et al. The role of maintenance strategies in metastatic colorectal cancer: A systematic review and network meta-analysis of randomized clinical trials. JAMA Oncol 2019; 6: e194489