THE IMPORTANCE OF STABILIZATION AS AN END-POINT IN THE TREATMENT OF METASTATIC COLORECTAL-CARCINOMA - RECENT QUALITY-OF-LIFE STUDIES

Assessment of the effectiveness of new anticancer chemotherapies in cl inical trials is usually based on the degree of objective response obt ained. Response is usually defined as 'complete', when there is comple te disappearance of all detectable tumor, or 'partial', when there is a 50% reduction in the sum of the products of the largest perpendicula r diameters of all measurable disease, with no new lesions (Advanced C olorectal Cancer Meta-analysis Project). Both clinicians, concerned wi th the welfare of their patients, and healthcare administrators, keen to be assured of cost-effectiveness within their restricted budgets, s ee such response (along with enhanced survival) as a cardinal indicato r of efficacy. Response rates are a primary influence on their decisio n to treat, or to sanction payment for treatment, with a particular me dication. There is, however, growing evidence to suggest that stabiliz ation of disease is also an important endpoint in chemotherapy for car cinoma, with important benefits for the patients' quality of life (QoL ). We report on recent international studies on the effects of the top oisomerase I inhibitor irinotecan (Campto(R)) as second-line treatment in patients with metastatic colorectal cancer. These confirm the valu e of stabilization, as well as response, in such patients, not only in bringing QoL benefits, but also in reducing length of hospitalization end hence costs. [(C) 1998 Lippincott Williams & Wilkins.].