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Colorectal Cancer — SCE Medical Oncology MCQ

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ModerateGI CancersColorectal CancerSCE Medical Oncology

A 68-year-old woman with metastatic colorectal cancer has a good partial response to FOLFOX + bevacizumab after 8 cycles. She develops cumulative grade 2 peripheral neuropathy. What is the recommended strategy?

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Correct answer: D — Oxaliplatin holiday — continue 5-FU/LV + bevacizumab maintenance; reintroduce oxaliplatin at progression

Planned oxaliplatin discontinuation (treatment holiday) after 6-8 cycles with continuation of fluoropyrimidine + bevacizumab is standard practice to manage cumulative neurotoxicity while maintaining disease control. The OPTIMOX1, OPTIMOX2 and CAIRO3 trials established this stop-and-go strategy. Oxaliplatin is reintroduced at disease progression. This approach preserves oxaliplatin sensitivity for reinduction while minimising irreversible neuropathy.

Reference: ESMO 2024 Metastatic Colorectal Cancer Guidelines; OPTIMOX1 Tournigand et al JCO 2006; CAIRO3