Current Status of Maintenance Systemic Therapies in Metastatic Colorectal Cancer: 2018 Update
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Purpose of Review
Current systemic management of MCRC includes periods of intensive induction treatment followed by surgery and/or local ablation or maintenance or complete stop. This article is an update of the 2017 review by Quidde et al. and evaluates the most recent data on maintenance strategies in MCRC.
Induction followed by maintenance and if feasible re-induction treatment does not seem to be inferior to continuous full-dose treatment for patients with MCRC responding to first-line combination regimen but without options for secondary resection or local ablation. Active maintenance seems to be superior to complete stop after at least 3 months of induction treatment in terms of progression-free survival and may add some benefit in terms of OS. The addition of PD-L1 inhibition to maintenance was not effective. The choice of the respective maintenance strategy may be personalised taking into account disease and patient characteristic, choice of induction treatment and response, treatment tolerability and quality of life.
Patients with MCRC and no options of secondary resection or local ablation should be considered for maintenance treatment.
KeywordsMetastatic colorectal cancer Personalised Induction Maintenance
Compliance with Ethical Standards
Conflict of Interest
Julia Mann declares that she has no conflict of interest.
Alexander Stein has received institutional research grants from Roche, Merck, Sanofi, Servier, and Bristol-Myers Squibb, and has received compensation for service on advisory boards from Roche, Merck, Sanofi, Servier, Bristol-Myers Squibb, and MSD.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance
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