Dr. McCollum on Maintenance Therapy for Metastatic CRC

A. David McCollum, MD, oncologist, Baylor University Medical Center, discusses maintenance therapy for patients with metastatic colorectal cancer (mCRC).

McCollum says that there are 4 studies that have helped to establish the role of maintenance therapy in mCRC—OPTIMOX1 and 2, CAIRO3, and PROT-AGE. The PROT-AGE study showed that single-agent bevacizumab (Avastin) in the maintenance setting does not provide much benefit over a chemotherapy-free interval. Still, these studies have shown that some form of maintenance is probably better than a chemotherapy-free interval. There are select patients for whom a chemotherapy-free interval might be appropriate, McCollum notes.

The best strategy in the treatment of patients with mCRC, he explains, is likely deintensifying to some form of maintenance therapy. It is still up for debate whether fluoropyridine, fluoropyridine plus an antibody, or an EGFR-directed antibody alone is the best option. McCollum says that the concept of transitioning from induction to a maintenance-type of treatment is important, and the message of that should be spread.