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Treatment Holiday mCRC — SCE Medical Oncology MCQ

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ModerateGI CancersTreatment Holiday mCRCSCE Medical Oncology

A 70-year-old man with metastatic CRC has achieved a complete response on FOLFOX + cetuximab. His oncologist discusses the concept of a 'treatment holiday'. What does this mean in the mCRC context?

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Correct answer: A — Planned interruption of chemotherapy (oxaliplatin holiday or complete treatment break) during a period of disease control, with planned reinduction at biochemical or radiographic progression — to reduce cumulative toxicity while maintaining treatment efficacy

Treatment holidays in mCRC involve planned cessation of all or part of the chemotherapy regimen during disease control. Strategies include: (1) oxaliplatin stop-and-go (OPTIMOX1: stop oxaliplatin after 6 cycles, continue 5-FU/LV ± biologic), (2) complete chemotherapy-free interval (MRC COIN-B), (3) maintenance therapy de-escalation (fluoropyrimidine ± biologic). These approaches reduce cumulative toxicity (neuropathy, fatigue) without significantly compromising OS. Treatment is reinduced at progression (biochemical: rising CEA; or radiographic).

Reference: ESMO 2024 mCRC; OPTIMOX1; CAIRO3; MRC COIN-B