Source: DGNews  |  Posted 2 years ago

By Ed Susman

ORLANDO, Fla -- January 25, 2010 -- Patients receiving chemotherapy for
advanced colorectal cancer may be able to take drug holidays without
significantly risking disease progression, researchers reported here at the
2010 Gastrointestinal Cancers Symposium (ASCO-GI).

“In this trial there is a difference in median survival of 1.4 months in the
intent-to-treat population in favour of continuous therapy, but this increase
did not meet the test of statistical superiority,” said Richard Adams, MD,
Velmore Hospital, Cardiff, United Kingdom, on January 24.

While there may be a marginal survival benefit, Dr. Adams said that the study
found patients who were assigned to intermittent therapy -- based on tumour
progression -- did not have as much peripheral neuropathy or hand-foot syndrome
as those on continuous treatment with oxaliplatin-based treatment.

The patients in the intermittent treatment group also were off chemotherapy
drugs about 2.3 months longer than those on continuous treatment in the
48-month trial.

“Our take-home message from this trial is that intermittent therapy remains a
good option of care for optimal therapy in the individual patient with advanced
colorectal cancer as time off therapy, improved quality of life, and reduced
toxicity can be gained without loss of survival in selected patients,” said Dr.
Adams.

“We were attempting to show that the intermittent therapy was noninferior to
continuous therapy,” he said. “We set a fairly high bar for noninferiority, and
we didn’t meet that statistical level. However, we did not show that continuous
treatment was superior to intermittent therapy, either.”

Median survival among the 815 patients taking continuous therapy was 15.8
months; median survival among the 815 patients in the intermittent therapy
group was 14.4 months. Two-year survival was 28.7% among those on continuous
therapy and 26.5% among those on intermittent therapy.

Patients were randomised to receive continuous oxaliplatin plus 5-fluorouracil
and leucovorin every 2 weeks or oxaliplatin plus capecitabine every 3 weeks
until treatment failure. Those who received intermittent therapy were monitored
and if progression occurred, the patients were re-treated for another 12 weeks.

The study was supported by Cancer Research UK and the UK Medical Research
Council Clinical Trials Unit.

The 2010 Gastrointestinal Cancers Symposium is sponsored by the American
Gastroenterological Association Institute, the American Society of Clinical
Oncology, the American Society for Therapeutic Radiation Oncology, and the
Society of Surgical Oncology.

[Presentation title: Intermittent Versus Continuous Oxaliplatin-Based
Combination Chemotherapy (CT) in First-Line Treatment of Patients (pts) With
Advanced Colorectal Cancer (aCRC): First Analysis of Quality of Life (QL) and
Updated Efficacy Results From the MRC COIN Trial. Abstract 403]