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.