Determinants of choice in offering drug holidays during first-line therapy for metastatic colorectal cancer

Background:"Drug holidays" (DH) for metastatic colorectal cancer (mCRC) were introduced to preserve quality of life. We studied factors associated to a DH offer in first line.Materials & methods:We retrospectively analyzed 754 consecutive patients treated with chemotherapy for mCRC in two Italian institutions between 2005 and 2017. Associations between baseline clinical-pathological factors and DH (56 or more days of treatment interruption) were investigated.Results:In 754 patients, previous metastasectomy, previous thermoablation and previous surgery of primary tumor were independently associated with DH. Excluding procedures or clinical trials: primary rectal cancer and resection of primary tumor were significantly associated to DH.Conclusions:DH was offered to patients with lower burden of disease, but further investigations are needed to safely guide a holiday strategy.