Oxaliplatin is an intravenously administered platinum-containing compound that forms crosslinks between DNA strands, and between one part of a strand and another. These crosslinks inhibit DNA replication and transcription. When used in combination with 5-FU, oxaliplatin exhibits greater antiproliferative activity than what is observed with either compound alone. Oxaliplatin is indicated, along with 5-FU and leucovorin, for the adjuvant treatment of Stage III colon cancer in patients who have undergone complete resection of the primary tumor, and the treatment of advanced CRC. The prescribing information for oxaliplatin has a boxed warning related to the potential for anaphylaxis. Oxaliplatin is also associated with peripheral neuropathy and mild to moderate hematologic toxicity.

The NCCN guidelines recommend the use of oxaliplatin in combination with 5-FU/LV or capecitabine as adjuvant therapy for patients with intermediate-risk or high-risk Stage II or Stage III colon cancer. Regimens that contain oxaliplatin in combination with other agents are included as options for the initial treatment of patients with advanced or metastatic colon cancer who are able to receive intensive therapy. Combination regimens containing either 5-FU/LV or capecitabine with oxaliplatin are also recommended as a neoadjuvant or adjuvant therapy for patients with rectal cancer. Regimens that contain oxaliplatin in combination with other agents are included as options for the initial treatment of patients with advanced or metastatic rectal cancer who are able to receive intensive therapy.