MOMA Study

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

The purpose of this study is to evaluate -in patients with metastatic colorectal disease- the effectiveness of the addition of metronomic chemotherapy with cyclophosphamide and capecitabine to bevacizumab as maintenance therapy after an initial induction phase with FOLFOXIRI plus bevacizumab