Determinants of choice in offering drug holidays during first-line therapy for metastatic colorectal cancer

Future Oncol. 2020 Nov;16(32):2645-2660. doi: 10.2217/fon-2020-0270. Epub 2020 Aug 10.

Abstract

Background: 'Drug holidays' (DH) for metastatic colorectal cancer (mCRC) were introduced to preserve quality of life. We studied factors associated to a DH offer in first line. Materials & methods: We retrospectively analyzed 754 consecutive patients treated with chemotherapy for mCRC in two Italian institutions between 2005 and 2017. Associations between baseline clinical-pathological factors and DH (56 or more days of treatment interruption) were investigated. Results: In 754 patients, previous metastasectomy, previous thermoablation and previous surgery of primary tumor were independently associated with DH. Excluding procedures or clinical trials: primary rectal cancer and resection of primary tumor were significantly associated to DH. Conclusions: DH was offered to patients with lower burden of disease, but further investigations are needed to safely guide a holiday strategy.

Keywords: chemotherapy; colorectal cancer; drug holidays; metastasis.

MeSH terms

  • Clinical Decision-Making
  • Colorectal Neoplasms / diagnosis
  • Colorectal Neoplasms / epidemiology*
  • Colorectal Neoplasms / therapy
  • Disease Management
  • Health Care Surveys
  • Humans
  • Neoplasm Grading
  • Neoplasm Staging
  • Retrospective Studies