Colorectal cancer is the third most common tumour in men, the second in women and second place in cancer-related cause of death in the world. Mortality has declined over the years for several reasons, including colorectal cancer screening and more effective systemic therapies in both the adjuvant setting and metastatic disease.   Adjuvant therapies for colon cancer have evolved over the past 40 years. Early studies failed to show overall survival (OS) benefit of single agent therapy including 5-fluorouracil (5-FU) monotherapy compared with surgery alone. Adjuvant leucovorin modulated 5-FU (5-FU/LV) did, however, improve relative OS, but not absolute OS due to the increased incidence, and has been the standard of care since the mid-nineties. As of 2004, standard adjuvant therapy consists of a 5-FU/LV-based backbone to which oxaliplatin was added. Oxaliplatin did improve disease-free survival (DFS) and OS in stage III patients but it commonly caused substantial late toxicity (LT) with peripheral sensory neurotoxicity (PSN). Other agents including irinotecan, cetuximab and bevacizumab tested in the adjuvant setting, failed to show additional OS benefit.