Background of the study
Recent results by our group have shown that the use of a triple chemotherapy including the three active drugs in colorectal cancer (5-FU, Irinotecan and Oxaliplatin, according to the scheme FOLFOXIRI) associated with the inhibitor of angiogenesis bevacizumab, followed by a phase of lighter treatment (called "maintenance") shows a significant benefit compared to the combination of two of the three drugs used (5-FU and Irinotecan, in the FOLFIRI scheme) in combination with bevacizumab.
Following this project, a new question arose: how to definitively prove whether the use of the three drugs together gives a benefit compared to the sequential use of the same drugs? Which benefit can be derived from the reintroduction of chemotherapy with the same combination of FOLFOXIRI + bevacizumab at the time of disease progression once established a phase of "maintenance"?
Aim of the study
The aim of the study is to analyze what is the best option between a “standard” strategy currently used according the best international guidelines that involves the use of a chemotherapy with two drugs and an inhibitor of angiogenesis (FOLFOX + bevacizumab) and, in case of progression, the use of another doublet of chemotherapy associated with the same angiogenic inhibitor (FOLFIRI + bevacizumab) compared to the use of the combination of three chemotherapy agents in first line (FOLFOXIRI + bevacizumab) and, in case of progression, the reintroduction of the same scheme.