Sequential Chemotherapy as Effective as Concurrent Chemotherapy in Advanced CRC

Sequential Chemotherapy as Effective as Concurrent Chemotherapy in Advanced Colorectal Cancer

According to results recently published in The Lancet, sequential administration of chemotherapy appears just as effective as concurrent administration among patients with advanced colorectal cancer.

Advanced colorectal cancer refers to cancer that has spread from its site of origin to more distant sites in the body. Typically, chemotherapy is used as part of the treatment regimen for advanced colorectal cancer. There are several chemotherapy agents from which to choose for treatment of this disease; however, the optimal combination and timing of administration has not yet been established.

Researchers affiliated with the CAIRO (capecitabine, irinotecan, and oxaliplatin in advanced colorectal cancer) trial recently conducted a clinical trial to compare sequential to combination chemotherapy in the treatment of advanced colorectal cancer. This trial included 820 patients from the Netherlands who were treated with one of the following treatment regimens:

  1. Sequential administration-treatment with Xeloda, followed by treatment with Camptosar, followed by treatment with Xeloda plus Eloxatin.
  2. Combination administration-treatment with Xeloda plus Camptosar, followed by treatment with Xeloda plus Eloxatin.

All patients were treated for at least six months, until their cancer progressed or side effects were too severe, before they progressed to their subsequent treatment.

  • Overall survival was not significantly different between the two groups of patients.
  • Severe side effects did not differ significantly between the two groups, except for hand–foot syndrome (pain, swelling, peeling, sores of palms of hands or soles of feet), which occurred more often in the group treated with sequential chemotherapy.

The researchers concluded that sequential chemotherapy appears just as effective as combination chemotherapy for the treatment of advanced colorectal cancer. Patients with advanced colorectal cancer may wish to speak with their physician regarding their individual risks and benefits of sequential or combination chemotherapy.

Reference: Koopman M, Antonini N, Douma J, et al. Sequential versus combination chemotherapy with capecitabine, irinotecan, and oxaliplatin in advanced colorectal cancer (CAIRO): a Phase III randomised controlled trial. The Lancet. 2007; 370:135-142.

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