New research in the October 2023 issue of JNCCN—Journal of the National Comprehensive Cancer Network finds that intensive local-regional treatment to remove as much tumor as possible (known as “debulking”), in addition to standard systemic therapy, does not impact overall quality of life significantly for people with metastatic colorectal cancer.
The researchers examined the ongoing ORCHESTRA trial (NCT01792934) to compare patients treated with standard palliative chemotherapy alone to those who received palliative chemotherapy plus either surgery, ablative therapy, and/or radiotherapy to reduce their tumor burden. 300 patients were randomized to receive standard care or additional intervention. Significant adverse events were reported in 21% of patients in the standard group and 43% of patients who also received tumor debulking. However, there were no statistical or clinically relevant differences according to patient-reported outcomes for overall health-related quality of life or fatigue.
The study focused on the results from a preplanned exploratory secondary endpoint of Health-Related Quality of Life (HRQoL) from the ORCHESTRA trial, which was measured using the EORTC Quality of Life Questionnaire-Core 30 and the Multidimensional Fatigue Inventory questionnaire at pre-specified time points during treatment. The intervention group included first-line FOLFOX or CAPOX +/- bevacizumab plus multi-organ debulking to reduce the tumor by at least 80%. That was compared to the control group of palliative systemic chemo-biologic therapy only.
