Intermittent versus continuous oxaliplatin and fluoropyrimidine combination chemotherapy for first-line treatment of advanced colorectal cancer: results of the randomised phase 3 MRC COIN trial
2011

Intermittent vs Continuous Chemotherapy for Advanced Colorectal Cancer

Sample size: 1630 publication 10 minutes Evidence: moderate

Author Information

Author(s): Richard A Adams, Angela M Meade, Matthew T Seymour, Richard H Wilson, Ayman Madi, David Fisher, Sarah L Kenny, Edward Kay, Elizabeth Hodgkinson, Malcolm Pope, Penny Rogers, Harpreet Wasan, Stephen Falk, Simon Gollins, Tamas Hickish, Eric M Bessell, David Propper, M John Kennedy, Richard Kaplan, Timothy S Maughan

Primary Institution: MRC Clinical Trials Unit, London, UK

Hypothesis

Is intermittent chemotherapy non-inferior to continuous chemotherapy in terms of overall survival for patients with advanced colorectal cancer?

Conclusion

Intermittent chemotherapy did not show non-inferiority to continuous chemotherapy in overall survival, but it may offer benefits in quality of life and reduced treatment time for some patients.

Supporting Evidence

  • Median survival was 15.8 months for continuous therapy and 14.4 months for intermittent therapy.
  • Patients with normal platelet counts had no detriment in survival with intermittent therapy.
  • Intermittent therapy was associated with improved quality of life measures.

Takeaway

This study looked at two ways to give chemotherapy to cancer patients: one way is to keep giving it all the time, and the other way is to take breaks. It found that taking breaks didn't help patients live longer, but it might make them feel better while they are being treated.

Methodology

A randomised controlled trial comparing continuous and intermittent chemotherapy in patients with untreated advanced colorectal cancer.

Potential Biases

Treatment allocation was not masked, which could introduce bias.

Limitations

The trial did not meet its primary outcome objective of non-inferiority, and the results may not be generalizable to all patient populations.

Participant Demographics

Patients were adults aged 18 and older with histologically confirmed adenocarcinoma of the colorectum.

Statistical Information

P-Value

p=0.0018

Confidence Interval

80% CI 1·008–1·165

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1016/S1470-2045(11)70102-4

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