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In patients with low risk (T1-3, N1), dMMR colon cancer receiving adjuvant FOLFOX or CAPOX plus atezolizumab, do you recommend a 3-month, 6-month duration of chemotherapy or skipping it altogether?
In the ATOMIC trial evaluating the addition of adjuvant atezolizumab in this setting, patients received 6 months of chemotherapy plus 12 months of total atezolizumab. However, given the IDEA data, would you consider 3 months of chemotherapy to be adequate in this population? And given the data from metastatic disease, is chemotherapy needed in this setting?
Answer from: Medical Oncologist at Community Practice
This is a good question (and a data-free zone). pMMR low-risk stage III disease can be treated with 3 months of CAPOX or 6 months of FOLFOX, based on the IDEA trial. The residual risk of relapse for this entity, after chemotherapy, is ~20%. FOLFOX for 3 months was inferior to 6 months by a few perce...
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