This site is intended for healthcare professionals

Go to /sign-in page

You can view 5 more pages before signing in

Non-surgical treatment of colorectal cancer

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Seek expert advice.

Colorectal carcinomas are relatively unresponsive to chemotherapy but liver metastases may occasionally be controlled by 5-fluorouracil (5 FU).

Test for RAS and BRAF V600E mutations in all people with metastatic colorectal cancer suitable for systemic anti-cancer treatment

Adjuvant chemotherapy in rectal cancer

  • consider adjuvant chemotherapy for patients with high-risk stage II and all stage III rectal cancer to reduce the risk of local and systemic recurrence

Adjuvant chemotherapy for colon cancer

  • consider adjuvant chemotherapy after surgery for patients with high-risk stage II colon cancer
  • options for the adjuvant treatment of patients with stage III (Dukes' C) colon cancer following surgery for the condition:
    • capecitabine as monotherapy
    • oxaliplatin in combination with 5-fluorouracil and folinic acid

Chemotherapy for advanced and metastatic colorectal cancer

  • when offering multiple chemotherapy drugs to patients with advanced and metastatic colorectal cancer, consider one of the following sequences of chemotherapy unless they are contraindicated:
    • FOLFOX (folinic acid plus fluorouracil plus oxaliplatin) as first-line treatment then single agent irinotecan as second-line treatment or
    • FOLFOX as first-line treatment then FOLFIRI (folinic acid plus fluorouracil plus irinotecan) as second-line treatment or
    • XELOX (capecitabine plus oxaliplatin) as first-line treatment then FOLFIRI (folinic acid plus fluorouracil plus irinotecan) as second-line treatment.

Biological therapy in metastatic colorectal cancer

  • pembrolizumab is recommended as an option for untreated metastatic colorectal cancer with high microsatellite instability (MSI) or mismatch repair (MMR) deficiency in adults (3)

Reference:


Related pages

Create an account to add page annotations

Add information to this page that would be handy to have on hand during a consultation, such as a web address or phone number. This information will always be displayed when you visit this page