Personalizing Maintenance Therapy in Metastatic Colorectal Cancer

Abstract

Purpose of Review

Current systemic management of MCRC should include periods of intensive and less intensive treatment or even complete stop. Different systemic post-induction strategies have been evaluated in many trials. The aim of this article is to review the available data on maintenance strategies in MCRC and potential options to personalize choice of the respective strategy.

Recent Findings

Despite the large variability of clinical trials conducted in this setting, it can be concluded that intermittent chemotherapy does not seem to be inferior to continuous chemotherapy if at least 3 months of intensive induction treatment is applied, and active maintenance seem to be superior to complete stop after at least 3 months of induction treatment in terms of PFS and may add some benefit in terms of OS. The choice of the respective maintenance strategy may be personalized taking into account disease and patient characteristic, choice of induction treatment and response, treatment tolerability and quality of life.

Summary

Patients with metastatic colorectal cancer and no options of secondary resection or local ablation should be considered for a personalized maintenance approach.

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