Stabilisation in colorectal cancer

Stabilisation of disease (as well as objective response) is an important outcome in the treatment of cancer. To test the hypothesis that chemotherapy brings positive Quality of Life (QoL) benefits when disease stabilisation is achieved, a utility study involving 30 UK nurses experienced in oncology care has been carried out. Acting as proxies for cancer patients, the nurses were asked to assess the values of various health states associated with the treatment of metastatic colorectal cancer. The nurses rated the QoL benefits of stabilisation almost as highly as those of partial response (Utility score of 0.95 vs. 1). Side-effects associated with chemotherapy, however, mean that active management of toxicity is needed to preserve QoL benefits. More than 50% of metastatic colorectal cancer patients have a partial response or have their disease stabilised with the new topoisomerase I inhibitor (irinotecan, CAMPTO®). It is indicated for use when treatment with 5-fluorouracil (5-FU) has failed. Major side-effects are short-lived compared with treatment benefits, so it appears that, for patients who respond or who are stabilised, the QoL improvements will outweigh any short-term costs of toxicity.