Second-line chemotherapy in advanced and metastatic CRC

Roqué i Figuls M, Solà I, Martin-Richard M, López J-J, Bonfill Cosp X

Summary

Second-line chemotherapy may increase survival of patients with advanced or metastatic colorectal cancer that have failed a first chemotherapy treatment.

Patients with metastatic or advanced colorectal cancer are often treated with chemotherapy. If the disease doesn't improve with a specific chemotherapy regimen, a different chemotherapy regimen may be tried, called second-line treatment, with the aim to increase survival and improve quality of life. This review has identified a single trial comparing second-line chemotherapy with supportive care. Based on its results, chemotherapy may increase overall survival in 4 to 8 weeks with respect to supportive care. Although the review has identified six trials comparing different second-line chemotherapy regimens, no conclusive results were reached and it's not clear which is the optimal chemotherapy regimen. The review has failed to identify any evidence on third and subsequent lines of therapy, which thus are not currently supported by sound evidence.