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clinical / clinicalFOLFOX4 CRC, European CRC Guidelines & RAS Testing

Jean-Yves Douillard

让-伊夫·杜亚尔

MD, PhD

🏢ESMO (European Society for Medical Oncology) / ICO René Gauducheau(欧洲肿瘤内科学会(ESMO)/ ICO雷内·高迪肖癌症中心)🌐France

Past President, European Society for Medical Oncology (ESMO); Former Chief Medical Officer, ESMOESMO(欧洲肿瘤内科学会)前主席;ESMO前首席医疗官

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Key Papers
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Awards
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Key Contributions

👥Biography 个人简介

Jean-Yves Douillard, MD, PhD is a French medical oncologist and past President of the European Society for Medical Oncology (ESMO). He is a founding figure of modern colorectal cancer chemotherapy, best known for his leadership of the pivotal trials establishing FOLFOX4 (oxaliplatin, leucovorin, and 5-fluorouracil) as the standard backbone for metastatic and adjuvant CRC treatment. His landmark MOSAIC trial demonstrated that adding oxaliplatin to 5-FU/leucovorin (creating FOLFOX4) in the adjuvant setting significantly improved disease-free survival in stage II–III colon cancer patients, creating one of the most widely used regimens in oncology worldwide. Dr. Douillard subsequently led seminal biomarker studies establishing that extended RAS testing (KRAS and NRAS mutations in exons 2, 3, and 4) is essential before prescribing anti-EGFR therapies such as panitumumab, as patients with RAS mutations derive no benefit and may be harmed — a finding that changed global treatment guidelines and regulatory labeling. He served as ESMO President from 2013 to 2015 and as Chief Medical Officer, where he championed precision oncology frameworks and global guidelines harmonization. Dr. Douillard has authored more than 250 publications and is a fellow of multiple national and international oncology academies.

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🧪Research Fields 研究领域

FOLFOX4 Regimen Development in Metastatic CRC转移性结直肠癌FOLFOX4方案开发
RAS Biomarker Testing and Anti-EGFR Therapy in CRCRAS生物标志物检测与结直肠癌抗EGFR治疗
European Clinical Practice Guidelines for CRC欧洲结直肠癌临床实践指南
Panitumumab and Anti-EGFR Therapy in RAS Wild-Type CRCRAS野生型结直肠癌帕尼单抗与抗EGFR治疗
Adjuvant Chemotherapy in Stage III Colon CancerIII期结肠癌辅助化疗

🎓Key Contributions 主要贡献

MOSAIC Trial — FOLFOX4 as Adjuvant Standard in Stage III Colon Cancer

Led the MOSAIC phase III trial demonstrating that FOLFOX4 (oxaliplatin added to 5-FU/leucovorin) significantly improved 6-year disease-free survival (73.3% vs 67.4%) and overall survival in stage III colon cancer compared to 5-FU/leucovorin alone, establishing FOLFOX4 as the global adjuvant standard of care and one of the highest-impact trials in gastrointestinal oncology.

Extended RAS Testing — Mandatory Biomarker Before Anti-EGFR Therapy

Conducted pivotal retrospective analyses of PRIME trial data demonstrating that patients with KRAS or NRAS mutations in any codon (extended RAS) derive no benefit and may have inferior outcomes with panitumumab plus FOLFOX4, establishing the requirement for extended RAS testing as a precondition for anti-EGFR therapy use in mCRC — a finding subsequently adopted into FDA and EMA labeling and ESMO/ASCO guidelines.

PRIME Trial — Panitumumab in RAS Wild-Type mCRC

Led the PRIME phase III trial evaluating panitumumab plus FOLFOX4 versus FOLFOX4 alone in first-line metastatic CRC, which demonstrated a progression-free and overall survival benefit restricted exclusively to RAS wild-type patients, providing the definitive evidence base for restricting anti-EGFR therapy to biomarker-selected populations.

ESMO Guidelines Leadership and European CRC Treatment Standardization

As ESMO President and CMO, led the development and international dissemination of ESMO Clinical Practice Guidelines for colon and rectal cancer, harmonizing molecular testing requirements, treatment sequencing recommendations, and multidisciplinary management standards across Europe and globally, including the ESMO consensus guidelines on liquid biopsy and ctDNA in CRC.

Representative Works 代表性著作

[1]

Oxaliplatin, fluorouracil, and leucovorin as adjuvant treatment for colon cancer (MOSAIC)

New England Journal of Medicine (2004)

MOSAIC trial establishing FOLFOX4 as adjuvant standard for stage III colon cancer with significantly improved disease-free and overall survival versus 5-FU/LV alone.

[2]

Panitumumab-FOLFOX4 treatment and RAS mutations in colorectal cancer (PRIME)

New England Journal of Medicine (2013)

Definitive PRIME biomarker analysis demonstrating that extended RAS testing is mandatory before prescribing panitumumab, with survival benefit restricted to RAS wild-type mCRC patients.

[3]

Randomized phase III trial comparing FOLFOX4 and FOLFIRI in patients with metastatic colorectal cancer

Journal of Clinical Oncology (2000)

Landmark trial establishing equivalent efficacy of FOLFOX4 and FOLFIRI in first-line metastatic CRC with different toxicity profiles, informing global first-line treatment selection strategies.

[4]

ESMO consensus guidelines for the management of patients with metastatic colorectal cancer

Annals of Oncology (2016)

Comprehensive ESMO consensus guidelines covering molecular testing, first- and second-line treatment, targeted therapy selection, and continuum-of-care strategies for metastatic CRC.

🏆Awards & Recognition 奖项与荣誉

🏆ESMO Presidential Distinction Award
🏆Ligue Nationale contre le Cancer Honored Researcher
🏆French National Academy of Medicine Fellow
🏆AACR International Award for Cancer Research
🏆ASCO Special Recognition Award for International Contributions

📄Data Sources 数据来源

Last updated: 2026-04-06 | All information from publicly available academic sources

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