A new study uncovers the best treatments to prolong survival for patients with advanced colorectal cancer, but researchers have a warning about their toxic effects.
Researchers from the University of Ioannina School of Medicine in Greece conducted a meta-analysis of 242 randomized trials to compare treatment regimens for patients with advanced colorectal cancer. The studies were pulled from the last 40 years to determine whether certain treatments were better at stabilizing the disease and prolonging survival than others.
Researchers report, for patients expected to live one year on a treatment of fluorouracil (Adrucil) and leucovorin, there was an absolute survival benefit of eight months when an additional treatment of irinotecan (Camptosar) plus bevacizumab (Avastin) was added. There was also a survival benefit noted after adding oxaliplatin (Eloxatin) plus bevacizumab or irinotecan plus oxaliplatin, though the success was less with a 4.7-month additional survival benefit.
The analysis is important, report researchers, because newer and more intense treatments have more toxicity. There is a need to determine just how beneficial particular treatments are so both doctors and patients can weigh the pros and cons.
Researchers acknowledge there has been success in prolonging the survival of patients with advanced colorectal cancer, but warn multi-drug treatment regimens can lead to serious toxic effects. They write, "The fluorouracil, leucovorin, irinotecan, plus bevacizumab regimen especially, which has the highest probability to be the best in improving survival ... might be complicated by up to 84.9 percent of grade 3 or 4 adverse events."
Researchers report further study is warranted to determine just how beneficial the newer treatment regimens are when weighed against their toxic effects.
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