Chemotherapy: Have a break

Although treatment of advanced-stage colorectal cancer (CRC) has improved in the past decade, most patients still spend the rest of their lives under harsh therapy from the moment they are diagnosed. First-line treatment usually involves 6 months of continuous chemotherapy resulting in severe toxic effects, mainly sensory neuropathy and hand–foot syndrome caused by oxaliplatin and fluoropyrimidines, respectively. Allowing the patients a break by interrupting treatment after short cycles and re-starting it upon disease progression, could help to improve their quality of life. However, intermittent administration can reduce the efficacy of the treatment and may render tumors resistant to therapy. To assess this, Richard Kaplan and his collaborators enrolled 1,630 patients to receive two different chemotherapy regimens (oxaliplatin plus capecitabine or oxaliplatin plus 5-fluorouracil) in a continuous fashion or in an intermittent way. Patients in the continuous arm received treatment until they developed progressive disease, cumulative toxic effects or chose to stop. Patients in the intermittent arm received treatment CHEMOTHERAPY