Maintenance treatment in metastatic colorectal cancer

Abstract

Susanna Hegewisch-Becker and colleagues reported the results of a randomised trial (AIO 0207) 1 Hegewisch-Becker S Graeven U Lerchenmüller CA et al. Maintenance strategies after first-line oxaliplatin plus fluoropyrimidine plus bevacizumab for patients with metastatic colorectal cancer (AIO 0207): a randomised, non-inferiority, open-label, phase 3 trial. Lancet Oncol. 2015; 16: 1355-1369 Summary Full Text Full Text PDF PubMed Scopus (188) Google Scholar comparing maintenance strategies in patients without disease progression after first-line induction treatment with oxaliplatin, a fluoropyrimidine, and bevacizumab in patients with metastatic colorectal cancer. The authors concluded that maintenance with a fluoropyrimidine plus bevacizumab might be the preferable option compared with bevacizumab alone or no treatment. Maintenance strategies after first-line oxaliplatin plus fluoropyrimidine plus bevacizumab for patients with metastatic colorectal cancer (AIO 0207): a randomised, non-inferiority, open-label, phase 3 trialAlthough non-inferiority for bevacizumab alone was demonstrated for the primary endpoint, maintenance treatment with a fluoropyrimidine plus bevacizumab may be the preferable option for patients following an induction treatment with a fluoropyrimidine, oxaliplatin, and bevacizumab, as it allows the planned discontinuation of the initial combination without compromising time with controlled disease. Only a few patients were exposed to re-induction treatment, thus deeming the primary endpoint time to failure of strategy non-informative and clinically irrelevant. Full-Text PDF Maintenance treatment in metastatic colorectal cancer – Authors' replySince the initiation of oxaliplatin-containing combination regimens more than a decade ago, an intense debate about treatment duration and maintenance treatment of metastatic colorectal cancer has been in progress. The debate continues because progression-free survival is often longer than the dose-cumulative occurrence of neuropathy in this setting. The complex and controversial discussion represents the perspectives, preferences, and treatment philosophies of physicians and patients, and the technical aspects in the assessment of this newly defined period of maintenance treatment to determine the real benefit for the right population. Full-Text PDF