Table 7. Randomised studies evaluating combination vs sequential treatment in advanced colorectal cancer.
| Study | Treatment arms | Number of patients | First line response rates | P-value | Median progression-free survival from first line treatment (months) | P-value | Median overall survival (months) | P-value |
|---|---|---|---|---|---|---|---|---|
| Seymour et al (2007a, 2007b) FOCUS | Strategy A 5-FU/LV → irinotecan | 710 | 28% (5-FU/LV) | 6.3 (5-FU/LV) | 13.9 | |||
| Strategy B 5-FU/LV → FOLFIRI or FOLFOX | 356 (FOLFIRI) 356 (FOLFOX) | 28% (5-FU/LV) | <0.001 (strategy C vs A or B) | 6.3 (5-FU/LV) | <0.001 (strategy C vs A or B) | 15.1 | NS | |
| Strategy C FOLFIRI → FOLFOX FOLFOX → FOLFIRI | 356 (FOLFIRI) 357 (FOLFOX) | 49% (FOLFOX or FOLFIRI) | 8.5 (FOLFOX or FOLFIRI) | 15.9 | ||||
| Koopman et al (2007) CAIRO | Strategy A capecitabine → irinotecan → CAPOX | 410 | 20% (capecitabine) | <0.0001 | 5.8 (capecitabine) | 0.0002 | 16.3 | 0.3281 |
| Strategy B CAPIRI → CAPOX | 410 | 41% (CAPIRI or CAPOX) | 7.8 (CAPIRI or CAPOX) | 17.4 | ||||
| Cunningham et al (2009) LIFE | Strategy A 5-FU/LV → irinotecan | 363 | 29.8% (5-FU/LV) | <0.0001 | 5.9 (5-FU/LV) | <0.0001 | 15.2 | 0.155 |
| Strategy B FOLFOX → irintoecan | 362 | 54.1% (FOLFOX) | 7.9 (FOLFOX) | 15.9 |
LV=leucovorin, FOLFOX=oxaliplatin/infused 5-FU/LV, FOLFIRI=irinotecan/infused 5-FU/LV, CAPOX=capecitabine/oxaliplatin, CAPIRI=capecitabine/irinotecan, NR=not reported, NS=non significant.