[Use of maintenance therapy and complete discontinuation for therapeutic management of non-resectable metastatic colorectal cancer]

Abstract

Management of unresectable metastatic colorectal cancer dramatically changed over the past 20 years. News standards of care combine cytotoxic drugs like fluoropyrimidines, irinotecan and oxaliplatin, with targeted therapies such as anti-EGFR monoclonal antibodies and anti-angiogenic agents. Survival benefit results from these new options but correlates with more exposure to chemotherapy and cumulative toxicities. The main concern for these patients remains to find the optimal balance between efficacy, toxicity and quality of life. This article reviewed the main studies designed to evaluate the concept of maintenance therapy after induction chemotherapy and discontinuation strategy. Available therapeutic standards and options to shorten duration of chemotherapy and reduce toxicities are reported and discussed.

Keywords: CCRm; CFI; CT; DCM; NS; PD; SG; SSP; TKI; bev; bévacizumab; cancer colorectal métastatique; cape; capécitabine; chemotherapy complete discontinuation; chemotherapy free interval; chimiothérapie; cétux; cétuximab; durée de contrôle de la maladie; inhibiteur de tyrosine kinase; intervalle libre sans chimiothérapie; maintenance therapy; metastatic colorectal cancer; non significatif; progressive disease; survie globale; survie sans progression.