Colorectal Cancer Patients Benefit From Chemotherapy Holidays: Presented at ASCO

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Title: Colorectal Cancer Patients Benefit From Chemotherapy Holidays: Presented at ASCO
URL: http://www.pslgroup.com/dg/222CC6.htm
Doctor's Guide
June 2, 2008

By Bruce Sylvester

CHICAGO -- June 2, 2008 -- A significant number of patients with advanced colorectal cancer can benefit from chemotherapy holidays, researchers reported here at the American Society of Clinical Oncology (ASCO) 44th Annual Meeting.

"We found that many patients with advanced colorectal cancer can benefit from a chemotherapy-free interval," said lead investigator Natalie Perez-Staub, MD, Hôpital St. Antoine, Paris, France, in a presentation on June 1. "And as chemotherapy enables patients to live longer, holidays become an even more important option."

Chemotherapy free-intervals (CFI) are sometimes permitted in patients with advanced colorectal cancer. However, the ongoing OPTIMOX2 study previously showed that CFI early after 6 courses of first-line treatment with 5-fluorouracil, leucovorin, and oxaliplatin was demonstrated to have negative effects on overall survival in patients with metastatic colorectal cancer (Maindrault-Goebel F et al. ASCO 2007. Abstract 4013)

To determine the best time to stop therapy and the predictive factors for a prolonged CFI, researchers conducted a retrospective analysis of the OPTIMOX2 study on

Optimox

subjects who had a 3-month CFI (n = 822) according to the time to CFI.

The analysis excluded patients who had R0 or R1 metastases resection after 3 months of CFI, surgery before 3 months of CFI, or progressive disease at time of CFI.

Each subject was matched with a subject who did not stop chemotherapy (CT), had progression-free survival (PFS) at least 3 months longer than time to CFI, and had similar baseline demographic characteristics.

The investigators reported that 31% of subjects who were eligible for this analysis (163/525) had a CFI of more than 3 months.

Median overall survival (OS) was 24 months in 65 subjects who stopped CT before 3 months, 42 months among subjects who stopped CT between 3 and 9 months (48 patients), and 44 months among subjects who stopped CT after 9 months (50 patients; P < .0002).

Prognostic factors in the multivariate analysis were baseline alkaline phosphatase (ALP) level and number of metastatic sites.

The investigators found no correlation between time to CFI and CFI duration. And they found no difference in survival from CFI according to time to CFI.

They found a statistically significant difference in OS between all patients who had a 3-month CFI (37.5 months) versus their matched patients who did not have CFI (21.2 months, P < .0001).

"A significant number of patients can benefit from chemotherapy holidays," the authors concluded. "Baseline characteristics do not allow [us] to select these patients. Additional studies will be done to identify other factors which may help [us] to offer CFI to patients with advanced colorectal cancer."

[Presentation title: Who Can Benefit From Chemotherapy Holidays After First-Line Therapy For Advanced Colorectal Cancer? A GERCOR Study. Abstract 4037]

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