Connie Lai, MD, is a medical oncology resident at Queen Elizabeth Hospital, Hong Kong.

Dr Lai on Post-Induction Treatment Strategies in mCRC  

"This is a good insight for us to have, [as it gives us] more evidence to say whether the patients should receive maintenance or they should go on the treatment break. We plan to gather more toxicity profile data as well…[and in] the future [might conduct] a quality of life analysis."

Connie Lai, MD, a medical oncology resident at Queen Elizabeth Hospital in Hong Kong, shared findings from a retrospective, dual-center study evaluating post-induction treatment strategies in metastatic colorectal cancer (mCRC).

The study aimed to address the ongoing clinical question of whether patients should continue with maintenance therapy or take a treatment break following induction chemotherapy.

From an initial cohort of 5194 screened patients, 372 met the eligibility criteria, yielding 186 propensity score–matched pairs for analysis. Results presented at the 

2025 ESMO Gastrointestinal (GI) Cancers Congress

 demonstrated a statistically significant survival benefit with maintenance therapy compared with treatment breaks. The median overall survival (OS) was approximately 35 months in the maintenance group vs 23 months in the treatment break group (HR, 0.55), while median progression-free survival (PFS) was approximately 14 months vs 9 months, respectively. Both OS and PFS advantages were statistically significant, supporting the value of continued therapy beyond induction.

Subgroup analyses provided additional insights, particularly for patients with a higher disease burden, Lai continued. Those with more than 3 metastatic sites appeared to derive greater benefit from maintenance therapy, reinforcing the potential role of disease extent in guiding treatment decisions Lai noted that the findings are especially relevant in the modern treatment era, where monoclonal antibodies frequently complement chemotherapy in the metastatic setting.

Although the data support the use of maintenance therapy, questions remain regarding the balance between efficacy and long-term tolerability, Lai said. She emphasized the importance of further evaluating toxicity profiles and, ideally, assessing patient-reported outcomes in prospective trials. Future investigations incorporating quality-of-life end points may be conducted to address these questions, Lai concluded.

Videos

Connie Lai, MD, discusses an analysis of post-induction maintenance vs treatment break in metastatic colorectal cancer.
 

Dr Lai on Post-Induction Treatment Strategies in mCRC

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In today’s episode, we had the pleasure of speaking with Connie Lai, MD, a medical oncology resident at Queen Elizabeth Hospital in Hong Kong, about a retrospective, dual-center study examining post-induction treatment strategies in metastatic colorectal cancer (mCRC)

In our exclusive interview, Dr Lai discussed how this study addressed the ongoing lack of consensus regarding whether patients with mCRC should continue maintenance therapy or take a treatment break following induction chemotherapy. She detailed the study’s methodology, including propensity score–matched analyses comparing patients who received maintenance therapy with those who paused treatment, as well as the key findings demonstrating superior overall and progression-free survival with maintenance therapy. Dr Lai also highlighted subgroup observations suggesting enhanced benefit among patients with more than 3 metastatic sites, and she reflected on the implications of these findings in the modern treatment era, particularly in the context of monoclonal antibody use.

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Connie Lai, MD, discusses a retrospective, dual-center study examining post-induction treatment strategies in metastatic colorectal cancer. 

Connie Lai, MD

Articles

Dr Lai on Post-Induction Treatment Strategies in mCRC

Retrospective Data Highlight Improved Efficacy With Maintenance Therapy vs Treatment Breaks in mCRC: With Connie Lai, MD