A trial looking at chemotherapy for advanced bowel cancer (FOCUS)

Cancer type:

Bowel (colorectal) cancer

Colon cancer

Rectal cancer

Status:

Results

Phase:

Phase 3

This trial was comparing different ways of treating colorectal cancer that has spread outside the bowel or to another part of the body.

Doctors usually treat advanced bowel cancer with chemotherapy. The drug most often used is called 5FU. Two other drugs used to treat advanced bowel cancer are irinotecan and oxaliplatin.

This trial compared 5FU alone with a combination of either 5FU and irinotecan or 5FU and oxaliplatin. It also looked at having 5FU alone until the cancer started to grow again and then starting irinotecan on its own or a combination of irinotecan and 5FU or oxaliplatin and 5FU.

The aims of the trial were to find out

Which drug or combination of drugs worked best for advanced bowel cancer
Whether the order in which people had the drugs made a difference

Summary of results

The trial team found that having the combination of 5FU and irinotecan from the start worked a bit better than the other ways of having chemotherapy.

The trial recruited 2,135 people.

A third of them (group A) had 5FU alone followed by irinotecan when their cancer started to grow again
A third (group B) had 5FU alone and then a combination of 5FU and either irinotecan or oxaliplatin when their cancer started to grow again
A third (group C) had a combination of 5FU and either irinotecan or oxaliplatin from the beginning

22% of people in group A were alive 2 years after treatment, 25% in group B and 28% in group C. But when the researchers looked at the results in more detail, they found that only the combination or irinotecan and 5FU in group C stood out as better than the others.

People having 5FU alone had fewer side effects than people having a combination of 2 drugs. But in a quality of life study, people in all 3 groups rated their quality of life about the same after 3 months and 6 months of treatment.

When they published their results, the researchers pointed out that there was so little difference in the results for all 3 groups that doctors may give chemotherapy for advanced bowel cancer in different ways, depending on the individual situation.

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.