Adams Richard, Meade Angela, Wasan Harpreet, Griffiths Gareth, Maughan Tim
Velindre Hospital Cancer Centre, Velindre Road, Whitchurch, Cardiff, CF14 2TL, UK.
Expert Rev Anticancer Ther. 2008 Aug;8(8):1237-45. doi: 10.1586/14737140.8.8.1237.
The aim of palliative chemotherapy is to increase survival whilst maintaining maximum quality of life for the individual concerned. It is evident that the survival advantage offered by palliative chemotherapy for metastatic colorectal cancer has increased incrementally with the addition of each newly licensed therapeutic agent. More recently, advances in the field have led to the introduction of targeted monoclonal antibodies, whose benefits are documented in clinical trials and are acknowledged in their approval and licensing. Whilst we are continuing to explore the optimum use of the more traditional chemotherapy agents, with respect to both quantity and quality of life, these novel agents are battling to find their optimum place in the armamentarium. It is evident that a continuing add-one-in policy is likely to be detrimental to both patient and budget. Defining the positioning and duration of these combination therapies has become the subject of much debate and numerous current clinical trials. The Medical Research Council COIN trial is one of these trials, with a remit to explore further the optimum use of both standard agents and novel agents in the first-line setting for metastatic colorectal cancer.
姑息性化疗的目的是在维持患者最大生活质量的同时提高生存率。显然，随着每一种新获批治疗药物的加入，姑息性化疗为转移性结直肠癌带来的生存优势在逐步增加。最近，该领域的进展促使了靶向单克隆抗体的引入，其益处已在临床试验中得到记录，并在获批和许可过程中得到认可。在我们继续探索更传统化疗药物在生活质量和数量方面的最佳使用方法时，这些新型药物正在努力在现有药物中找到其最佳位置。显然，持续的“加一”策略可能对患者和预算都不利。确定这些联合疗法的定位和持续时间已成为众多讨论的主题以及当前众多临床试验的内容。医学研究委员会的COIN试验就是其中之一，其任务是进一步探索标准药物和新型药物在转移性结直肠癌一线治疗中的最佳使用方法。
