title: [Use of maintenance therapy and complete discontinuation for therapeutic management of non-resectable metastatic colorectal cancer].
abstract: Management of unresectable metastatic colorectal cancer dramatically changed over the past 20 years. News standards of care combine cytotoxic drugs like fluoropyrimidines, irinotecan and oxaliplatin, with targeted therapies such as anti-EGFR monoclonal antibodies and anti-angiogenic agents. Survival benefit results from these new options but correlates with more exposure to chemotherapy and cumulative toxicities. The main concern for these patients remains to find the optimal balance between efficacy, toxicity and quality of life. This article reviewed the main studies designed to evaluate the concept of maintenance therapy after induction chemotherapy and discontinuation strategy. Available therapeutic standards and options to shorten duration of chemotherapy and reduce toxicities are reported and discussed.
authors: Service d'oncologie médicale de l'Institut de cancérologie de l'Ouest, site R.-Gauducheau, boulevard Jacques-Monod, 44805 Nantes Saint-Herblain cedex, France.
authors: Hélène
authors: H
authors: Senellart
authors: Service d'oncologie médicale de l'Institut de cancérologie de l'Ouest, site R.-Gauducheau, boulevard Jacques-Monod, 44805 Nantes Saint-Herblain cedex, France.
authors: Sandrine
authors: S
authors: Hiret
authors: Service d'oncologie médicale de l'Institut de cancérologie de l'Ouest, 2, rue Moll, 49933 Angers cedex 9, France.
authors: Véronique
authors: V
authors: Guerin-Meyer
authors: Service d'oncologie médicale de l'Institut de cancérologie de l'Ouest, site R.-Gauducheau, boulevard Jacques-Monod, 44805 Nantes Saint-Herblain cedex, France.
authors: Jaafar
authors: J
authors: Bennouna
mesh_terms: D020533:Angiogenesis Inhibitors / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000473:pathology; D066246:ErbB Receptors / Q000037:antagonists & inhibitors; D006801:Humans; D060828:Induction Chemotherapy; D060046:Maintenance Chemotherapy / Q000009:adverse effects / Q000379:methods*; D058990:Molecular Targeted Therapy / Q000009:adverse effects / Q000379:methods*; D011788:Quality of Life; D028761:Withholding Treatment
chemical_list: D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D000970:Antineoplastic Agents; D066246:ErbB Receptors
keywords: CCRm; CFI; CT; DCM; NS; PD; SG; SSP; TKI; bev; bévacizumab; cancer colorectal métastatique; cape; capécitabine; chemotherapy complete discontinuation; chemotherapy free interval; chimiothérapie; cétux; cétuximab; durée de contrôle de la maladie; inhibiteur de tyrosine kinase; intervalle libre sans chimiothérapie; maintenance therapy; metastatic colorectal cancer; non significatif; progressive disease; survie globale; survie sans progression