Background of the study
Recent progress has been made in the treatment of metastatic colorectal cancer. A previous study coordinated by our group, called TRIBE, showed that the association of the three main chemotherapy drugs active in this disease: fluorouracil, irinotecan, and oxaliplatin (FOLFOXIRI) in combination with bevacizumab allows to obtain better results than the standard therapy of two drugs combined with bevacizumab.
After a phase of more or less long-lamoma-studysting intensive treatment (the optimal duration is still debated), recent evidence supports the adoption of a so-called maintenance treatment, that is capable of consolidating the results obtained in the first stage of treatment (named induction). If the continuation of blockade of tumor angiogenesis throught bevacizumab is a fairly common approach, one main question remains open: which is the “best maintenance” to be proposed?
Preclinical studies and preliminary clinical evidence showed that a chemotherapy treatment called “metronomic”, that is administered at low doses and continuously, can represent an alternative strategy to affect tumor angiogenesis with an excellent tolerability profile.
Aim of the study