Several randomised trials have consistently shown that FOLFOX therapy results in superior response rates and time to disease progression in comparison with fluorouracil-leucovorin given as first- or secondline therapy in metastatic colorectal cancer. 49- 51 Irinotecan and oxaliplatin, each in combination with fluorouracil, are the new standard in the palliative treatment of colorectal cancer. Because of their superior effectiveness, triplet therapies consisting of either irinotecan or oxaliplatin in combination with infusional fluorouracil-leucovorin have become the standard treatment in the palliative situation. First results of interim efficacy and safety analysis from a study comparing FUFOX (weekly fluorouracil 2000 mg/m2 24 hour infusion, leucovorin 500 mg/m2, oxaliplatin 50 mg/m2) with CAPOX (capecitabine 1000 mg/m2 twice daily for days 1-14, oxaliplatin 70 mg/m2 on days 1 and 8; every three weeks) in 399 patients showed that CAPOX had a comparable efficacy and toxicity profile to FUFOX in the firstline treatment of advanced colorectal cancer. 60 Time to progression was eight months in the FUFOX group and 7.5 months in the CAPOX group. ...329 patients showing positive EGFR expression were randomly assigned to receive either cetuximab alone or in combination with irinotecan.). ...progress is on the horizon but can only take place through interdisciplinary cooperation and careful design, and completion of randomised clinical trials.