Is it sexy? No. Is it incredibly important for how we treat patients? Absolutely 🧠🧬 For over 20 years, 6 months of oxaliplatin plus a fluoropyrimidine has been the default for stage III colon cancer, and often high-risk stage II and rectal cancer. The cost has always been cumulative neuropathy that can follow patients for life ⚡️🖐️ The SCOT trial, the largest study in the IDEA collaboration, gives us long-term clarity with nearly 6,100 patients and more than 6 years of follow-up: 📊 5-yr DFS identical with 3 vs 6 months: 72.9% vs 72.9% 📈 5-yr OS identical: 82.4% vs 82.4% ✅ Noninferiority for OS formally met for 3 months Where this really matters clinically: 🟢 CAPOX clearly supports 3 months 🟢 Low-risk stage III shows no OS penalty 🟡 Even high-risk disease sees only tiny absolute OS differences ⚠️ Meanwhile, neuropathy nearly doubles when oxaliplatin is extended to 6 months. Many patients pay a lifelong price for minimal benefit. SCOT also uniquely included rectal cancer patients treated with upfront surgery, and here too, 3 months held up. This fits perfectly with modern TNT strategies 🧩 Takeaway: This isn’t flashy, but it’s foundational. For most patients with localized colon or rectal cancer, 3 months of adjuvant CAPOX is enough. Six months should be the exception, not the rule, and always a shared decision 🤝 Sometimes the most important advance is knowing when to stop. @OncoAlert @TheGutOncLab #GI26 ascopubs.org/doi/pdf/10.1200…