In Europe and the United States, the incidence of colon cancer accounts for the second place of malignant tumors, and the incidence of colon cancer in China is also increasing year by year. The prognosis of colon cancer is closely related to the stage, and the 5-year survival rate of patients with stage II and III colon cancer is 70%~80% after surgery, while postoperative adjuvant chemotherapy is important for improving both disease-free survival (DFS) and overall survival (OS) of colon cancer. Oxaliplatin-containing regimen Oxaliplatin in combination with 5FU/LV for adjuvant treatment of colon cancer can bring DFS and OS benefits at The 5-fluorouracil (5-FU)+calcium folinic acid regimen (5FU/LV) has been the standard regimen for adjuvant chemotherapy of colon cancer, and two clinical studies (MOSAIC and NSABPC-07) confirmed the value of oxaliplatin in combination with 5FU/LV, which has a milestone significance. The MOSAIC study enrolled a total of 2,246 patients after radical surgery for stage II and III colon cancer and compared the impact of treatment with a 5-FU + calcium folinic acid + oxaliplatin regimen (FOLFOX4) versus a 5FU/LV regimen with 5-FU continuous sedation (deGramont regimen) on DFS and OS. Previous results have shown that the addition of oxaliplatin significantly improved the 3-year DFS rate and 4-year OS compared with 5-FU continuous sedation.The latest follow-up results showed that the 5-year DFS rates in the FOLFOX4 group versus the 5-FU continuous sedation group were 73.3% and 67.4%, respectively [hazard ratio (HR) 0.8, P=0.003], and the 6-year OS rates were 78.5% and 76.0% (HR=0.84, P=0.046). This study conclusively clarified the DFS and OS improvement brought by oxaliplatin to adjuvant chemotherapy for colon cancer and demonstrated that the 3-year DFS benefit was a good predictor of the 5-year OS benefit. The NSABPC-07 study, on the other hand, compared the efficacy of a 5-FU/ LV regimen with 5-FU push (Roswell-Park regimen) with this regimen + oxaliplatin (FLOX). A total of 2,407 colon cancer patients were observed in this study, and at a median follow-up time of 42.5 months, the risk of death was reduced by 20% in the FLOX group (P<0.004), with a 3-year DFS rate of 76.1% and 71.8% in the FLOX group and the 5FU/LV alone group, respectively (P<0.01), and a 4-year DFS rate of 73.2% and 67.0% in the FLOX group and the 5FU/LV group, respectively (P<0.01 ), and 5-year OS rates were 80.3% and 78.3% (P=0.061), respectively. grade 3 or higher neurotoxicity was significantly increased in the FLOX group. Comparing the MOSAIC study with the NSABPC-07 study, the main difference was that the former used a continuous drip of 5-FU, whereas the latter used a push of 5-FU, and the total dose of oxaliplatin was 25% greater in the former than in the latter. Nonetheless, the results of both studies were similar, with significant improvements in DFS. This suggests, from another perspective, that there is also a benefit to adjuvant chemotherapy with small doses of oxaliplatin, and that 5-FU continuous titration is comparable in efficacy to push. Therefore, 5FU/LV alone is also a viable option when oxaliplatin cannot be continued in the later stages of adjuvant therapy. In addition, data from different phases show that the OS benefit becomes increasingly evident with increasing time. Capecitabine-containing regimen XELOX may serve as a new standard of care in the adjuvant treatment of early-stage colon cancer For capecitabine, an oral fluorouracil-based drug, the X-ACT study has demonstrated that its value for adjuvant therapy alone is similar to that of the intravenous push 5FU/LV regimen (Mayoclinic regimen). And on this basis, the NO16968 study evaluated the efficacy of capecitabine in combination with oxaliplatin (XELOX) versus 5FU/LV as postoperative adjuvant therapy in patients with stage III colon cancer. A total of 1886 patients with stage III colon cancer were enrolled in the study. The results showed that the 3-, 4-, and 5-year DFS rates in the XELOX group were 70.9%, 68.4%, and 66.1%, respectively, which were 4.5%, 6.1%, and 6.3% higher than that of the 5FU/LV group. recurrence-free survival (RFS) was significantly longer in the XELOX group compared with that of the 5FU/LV group (HR=0.78, P=0.0024). In addition, the safety profile of the XELOX regimen was similar to that of 5FU/LV in both patients under and over 65 years of age, suggesting that the regimen can be tolerated in older patients. The NO16968 study suggests that XELOX may serve as a new standard of care for the adjuvant treatment of early-stage colon cancer. So, could this regimen replace the FOLFOX regimen? Although there is a lack of direct comparative studies, the 5-year DFS of the XELOX group in the NO16968 study was 66.1%, which is consistent with the 5-year DFS of stage III patients in the FOLFOX4 group in the MOSAIC study, suggesting that the XELOX regimen and the FOLFOX4 regimen have comparable efficacy in the adjuvant treatment of stage III colon cancer. Chemotherapy combined with molecular targeted therapy Bevacizumab for the adjuvant treatment of colon cancer must be optimized for the duration of administration The addition of molecular targeted drugs to traditional chemotherapy has become the first-line standard treatment for advanced colon cancer, and the exploration of molecular targeted drugs for the adjuvant treatment is also progressively being conducted.The NSABPC-08 study evaluated for the first time the adjuvant therapeutic effect of bevacizumab in stage II and III colon cancer.2672 patients were randomized to receive mFOLFOX4. patients were randomized to receive 12 cycles of the mFOLFOX6 regimen or mFOLFOX6 + 1 year of bevacizumab. Bevacizumab treatment significantly reduced the risk of DFS events during the first six months to 1 year (HR=0.600, P=0004), with the initial advantage of bevacizumab fading with longer follow-up. This result suggests that further optimization of the dosing schedule is needed to assess the value of bevacizumab for adjuvant chemotherapy in colon cancer.