ALT-TRACC: Alternating oxaliplatin and irinotecan doublet schedules versus continuous doublet chemotherapy in previously untreated metastatic colorectal cancer: A treatment of recurrent and advanced colorectal cancer registry-based prospective randomised trial

Oxaliplatin-based or irinotecan-based doublet chemotherapy (with or without a biologic agent) is the current standard for metastatic colorectal cancer patients who are fit for doublet chemotherapy. Triplet chemotherapy (FOLFOXIRI) in the first-line setting improves overall survival compared to doublet chemotherapy but at the cost of increased toxicity. Alternating schedules of oxaliplatin and irinotecan doublets may increase efficacy by delivering all active agents in the first-line setting, while reducing toxicity associated with concurrent triplet chemotherapy.

ALT-TRACC aims to determine the efficacy of alternating oxaliplatin and irinotecan doublet chemotherapy +/- clinician’s choice biologic agent vs continuous doublet chemotherapy +/- clinician’s choice biologic agent in treatment for metastatic colorectal cancer treatment by reporting progression free survival on first line chemotherapy (PFS).