Metastatic Colorectal Cancer Clinical Trial
Official title:
A Phase III Trial of XELOX (Xeloda/Oxaliplatin) Followed by Xeloda Maintenance Versus Best Supportive Care (BSC) in Metastatic Colorectal Cancer
Colorectal cancer (CRC) accounts for 10% to 15% of all cancers and is the second leading
cause of cancer deaths in Western countries. Approximately half of all patients develop
metastatic disease and become candidates for the palliative chemotherapy which has been
proved to prolong survival and improve quality of life (QOL) in patients with metastatic
CRC. The most active chemotherapy regiments include oxaliplatin or irinotecan combined with
fluoropyrimidines.
With overall survival in metastatic CRC nowadays routinely around 2 years, the same
intensity of therapy can hardly be maintained throughout the course of therapy. The
continuum of care therefore mandates changes in therapy, with treatment breaks or phases of
less-intensive maintenance therapy interspersed with periods of more-intensive therapy to
control tumor progression. Thereby, chemo-holidays conceivably reduce the cumulative
toxicities of chemotherapy, potentially prevent the unplanned, premature discontinuation of
therapy, preserve the ability to administer further phases of therapy, potentially maximize
the time on therapy, reduce cost, and could increase QOL for patients. Several trials have
tested the influence of chemo-holidays on patient outcome, with various rules on when to
stop which component of antitumor therapy as follows; 1) Completely stopping all therapeutic
agents, giving patients a completely chemotherapy-free interval (OPTIMOX-2, GISCAD), or 2)
Stopping only those agents associated with significant (cumulative) toxicity while
continuing other agents as maintenance therapy (OPTIMOX-1, Combined Oxaliplatin
Neurotoxicity Prevention Trial [CONcePT]).
Therefore, we'd like to test if capecitabine maintenance after 8 cycles of capecitabine
combine with oxaliplatin (XELOX) could prolong progression-free survival without
deterioration of QOL and toxicities in patients metastatic CRC.
n/a
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