Table 7 Randomised studies evaluating combination vs sequential treatment in advanced colorectal cancer

From: Treatment in advanced colorectal cancer: what, when and how?

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

 
  1. 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.