OPTIMOX1 — SCE Medical Oncology MCQ
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Correct answer: B — Pause oxaliplatin after induction, maintain fluoropyrimidine, then consider reintroduction
OPTIMOX1 limits cumulative neuropathy by pausing oxaliplatin after induction, maintaining fluoropyrimidine and considering oxaliplatin reintroduction later. Pause fluoropyrimidine after induction, maintain oxaliplatin, then consider reintroduction: this reverses the component stopped to limit cumulative neuropathy. Pause oxaliplatin after induction, maintain cetuximab, then consider reintroduction: cetuximab maintenance is not the OPTIMOX1 design and requires biomarker selection. Pause all treatment after induction, then consider oxaliplatin reintroduction: OPTIMOX1 retained fluoropyrimidine maintenance rather than a complete chemotherapy holiday. Pause oxaliplatin after induction, maintain irinotecan, then consider reintroduction: irinotecan was not the maintenance backbone in this FOLFOX stop-and-go strategy.
Reference: OPTIMOX1 randomised stop-and-go oxaliplatin study (Published January 2006): https://pubmed.ncbi.nlm.nih.gov/16421419/; NICE NG151 colorectal cancer: recommendations (Current NICE recommendations, accessed July 2026): https://www.nice.org.uk/guidance/ng151/chapter/Recommendations