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Current Status of Maintenance Systemic Therapies in Metastatic Colorectal Cancer: 2018 Update

  • Systemic Therapies in Colorectal Cancer (SM Kazmi, Section Editor)
  • Published:
Current Colorectal Cancer Reports

Abstract

Purpose of Review

Current systemic management of MCRC includes periods of intensive induction treatment followed by surgery and/or local ablation or maintenance or complete stop. This article is an update of the 2017 review by Quidde et al. and evaluates the most recent data on maintenance strategies in MCRC.

Recent Findings

Induction followed by maintenance and if feasible re-induction treatment does not seem to be inferior to continuous full-dose treatment for patients with MCRC responding to first-line combination regimen but without options for secondary resection or local ablation. Active maintenance seems to be superior to complete stop after at least 3 months of induction treatment in terms of progression-free survival and may add some benefit in terms of OS. The addition of PD-L1 inhibition to maintenance was not effective. The choice of the respective maintenance strategy may be personalised taking into account disease and patient characteristic, choice of induction treatment and response, treatment tolerability and quality of life.

Summary

Patients with MCRC and no options of secondary resection or local ablation should be considered for maintenance treatment.

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  1. Department of Oncology, Haematology, Bone Marrow Transplantation with Section Pneumology, University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany

    Julia Mann & Alexander Stein

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Correspondence to Julia Mann.

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Julia Mann declares that she has no conflict of interest.

Alexander Stein has received institutional research grants from Roche, Merck, Sanofi, Servier, and Bristol-Myers Squibb, and has received compensation for service on advisory boards from Roche, Merck, Sanofi, Servier, Bristol-Myers Squibb, and MSD.

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Mann, J., Stein, A. Current Status of Maintenance Systemic Therapies in Metastatic Colorectal Cancer: 2018 Update. Curr Colorectal Cancer Rep 15, 28–35 (2019). https://doi.org/10.1007/s11888-019-00426-2

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