Maintenance treatment in metastatic colorectal cancer: in search of the best strategy

Clin Transl Oncol. 2020 Aug;22(8):1205-1215. doi: 10.1007/s12094-019-02267-9. Epub 2020 Jan 2.

Abstract

Over the last 2 decades, the standard fluoropyrimidine-based chemotherapy backbone for metastatic colorectal cancer has been complemented by the addition of novel biological agents, achieving impressive increases in 5-year survival rates. Nonetheless, these new combinations have also entailed increases in toxicity, leading to evaluation of de-escalated chemotherapy regimens and "drug holiday" periods in attempts to reduce side effects and optimise quality of life without impairing efficacy. Here, we review the current and emerging evidence for maintenance schedules with chemotherapy and targeted agents, versus continuous treatment after induction treatment, in metastatic colorectal cancer patients.

Keywords: Bevacizumab; Chemotherapy; Colorectal cancer; Maintenance; Metastatic.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents / administration & dosage
  • Antineoplastic Agents / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Bevacizumab / administration & dosage
  • Camptothecin / administration & dosage
  • Camptothecin / analogs & derivatives
  • Capecitabine / administration & dosage
  • Cetuximab / administration & dosage
  • Clinical Trials as Topic
  • Colorectal Neoplasms / drug therapy*
  • Colorectal Neoplasms / pathology
  • Disease Progression
  • Erlotinib Hydrochloride / administration & dosage
  • Fluorouracil / administration & dosage
  • Fluorouracil / adverse effects
  • Humans
  • Induction Chemotherapy
  • Irinotecan / administration & dosage
  • Leucovorin / administration & dosage
  • Leucovorin / adverse effects
  • Maintenance Chemotherapy / methods*
  • Nervous System Diseases / chemically induced
  • Nervous System Diseases / prevention & control
  • Organoplatinum Compounds / administration & dosage
  • Organoplatinum Compounds / adverse effects
  • Oxaliplatin / administration & dosage
  • Oxaliplatin / adverse effects
  • Oxaloacetates / administration & dosage
  • Panitumumab / administration & dosage
  • Withholding Treatment

Substances

  • Antineoplastic Agents
  • Organoplatinum Compounds
  • Oxaloacetates
  • Oxaliplatin
  • Bevacizumab
  • Capecitabine
  • Panitumumab
  • Irinotecan
  • Erlotinib Hydrochloride
  • Cetuximab
  • Leucovorin
  • Fluorouracil
  • Camptothecin

Supplementary concepts

  • Folfox protocol
  • IFL protocol
  • XELOX