What is the FOCUS trial trying to find out?

The main aim of the trial is to find out whether it is better to use two chemotherapy drugs at the same time (combination chemotherapy), rather than having one chemotherapy drug at a time. The trial will also find out whether it is better to use combination chemotherapy from the start, or to keep it in reserve for use if the first treatment doesn’t work or stops working after a time (doctors call this second-line treatment).

Newer drugs

The trial involves the use of two newer chemotherapy drugs, irinotecan and oxaliplatin. These drugs may improve treatment because they work differently to the standard treatment of 5FU and folinic acid. Another possible advantage is that the newer drugs help people for whom 5FU is no longer working.

At the moment if advanced colorectal cancer stops responding to standard treatment with 5FU, irinotecan may then be given. In the trial either irinotecan or oxaliplatin will be given at the same time as 5FU (combination chemotherapy). This is to see if it can control the cancer for longer and improve symptoms more than irinotecan on its own.

The results of the trial will show the best way of giving irinotecan or oxaliplatin and if they are equally effective. The trial will also look at whether it is best to give either irinotecan or oxaliplatin with 5FU (combination chemotherapy) as a first treatment, or only if the cancer starts to develop after treatment with 5FU.

At the moment, there is no treatment that can cure advanced colorectal cancer. The aim of the FOCUS trial is to see if the new drugs can improve the length and quality of life for people with advanced colorectal cancer.