A trial looking at different ways of having chemotherapy after surgery for bowel cancer (PACT)

Cancer type:

Bowel (colorectal) cancer

Status:

Results

Phase:

Other

This trial was comparing chemotherapy through a drip into a vein with chemotherapy tablets after surgery to remove bowel cancer that was Dukes stage B or C.

Doctors often treat bowel cancer with surgery followed by chemotherapy. There are different ways of having chemotherapy – either as a drip into a vein (intravenous chemotherapy) or as tablets.

Doctors knew that both ways of having chemotherapy worked about as well as each other. The aims of this trial were to

Learn more about the side effects of each treatment
Find out which treatment patients preferred

Summary of results

The researchers found that more people preferred the intravenous chemotherapy.

The researchers planned to recruit 74 people. The people taking part were put into the treatment groups at random. Neither they nor their doctor could decide which treatment they had first. This is called randomisation.

Half would have had fluorouracil, along with a vitamin called folinic acid through a drip into a vein for 6 weeks, followed by capecitabine tablets for 6 weeks
Half would have had capecitabine tablets for 6 weeks first, followed by the fluorouracil and folinic acid intravenous chemotherapy

But after 40 people had started treatment, the trial was stopped because capecitabine tablets were causing much worse side effects than chemotherapy through a drip into a vein.

The side effects included diarrhoea, sore or red hands and feet (plantar-palmar syndrome) and tiredness.

Side effects were particularly bad when people started having capecitabine tablets after they had finished the intravenous chemotherapy. The researchers suggest that doctors need to be cautious if changing people’s treatment from chemotherapy that includes fluorouracil and folinic acid to chemotherapy that includes capecitabine tablets.

We have based this summary on information from the team who ran the trial. The information they sent us has been reviewed by independent specialists (peer reviewed Open a glossary item ) and published in a medical journal. The figures we quote above were provided by the trial team. We have not analysed the data ourselves.