Intermittent therapy in the palliative treatment of metastatic colorectal cancer

The treatment of metastatic colorectal cancer has evolved considerably over the past decade. The introduction of combination chemotherapy regimens including oxaliplatin and irinotecan with 5-fluorouracil have significantly improved clinical efficacy, and these are the current standard first-line therapies for metastatic colorectal cancer. Recent studies have demonstrated that the addition of biological agents to chemotherapy has further improved treatment outcome. With the increasing number of treatment options now available, comes the question of optimal duration of treatment in order to maximize clinical efficacy but also to maintain quality of life. In this review, we further discuss the evidence and role of intermittent therapy in the management of patients with metastatic colorectal cancer and again examine whether outcome is compromised by planned breaks in treatment.