Standing up for the sequential strategy

With an increasing number of options now available for the management of metastatic colorectal cancer (mCRC), clinicians face the challenge of how to use them most effectively. First-line cytotoxic ‘doublets’ increase response rates and time to progression compared with monotherapy. However, five recent studies showed no significant overall survival benefit for first-line combination therapy compared with a pre-planned sequential approach starting with fluoropyrimidine monotherapy. In one trial, initial