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| |  Intermittent Chemotherapy Remains a Good Option of Care for Patients With Advanced Colorectal Cancer: Presented at ASCO-GI 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]
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