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Efficacy and Safety of Modified FOLFOXIRI+α in the Treatment of Advanced and Recurrent Colorectal Cancer: A Single-center Experience
OBJECTIVE: In the treatment of advanced and recurrent colorectal cancer (ARCC), FOLFOXIRI regimens have been proven to be significantly superior to FOLFIRI in terms of the progression-free survival (PFS), response rate (RR), and overall survival (OS). Furthermore, the Tribe trial showed that the RR...
Autores principales: | , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Japanese Society of Internal Medicine
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7303458/ https://www.ncbi.nlm.nih.gov/pubmed/32074573 http://dx.doi.org/10.2169/internalmedicine.3274-19 |
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author | Kobayashi, Kazuma Yamaguchi, Shun Ito, Shinichiro Torashima, Yasuhiro Inoue, Yusuke Okada, Satomi Enjoji, Takahiro Tetsuo, Hanako Kuba, Sayaka Kosaka, Taiichiro Adachi, Tomohiko Hidaka, Masaaki Yamanouchi, Kosho Kanetaka, Kengo Takatsuki, Mitsuhisa Eguchi, Susumu |
author_facet | Kobayashi, Kazuma Yamaguchi, Shun Ito, Shinichiro Torashima, Yasuhiro Inoue, Yusuke Okada, Satomi Enjoji, Takahiro Tetsuo, Hanako Kuba, Sayaka Kosaka, Taiichiro Adachi, Tomohiko Hidaka, Masaaki Yamanouchi, Kosho Kanetaka, Kengo Takatsuki, Mitsuhisa Eguchi, Susumu |
author_sort | Kobayashi, Kazuma |
collection | PubMed |
description | OBJECTIVE: In the treatment of advanced and recurrent colorectal cancer (ARCC), FOLFOXIRI regimens have been proven to be significantly superior to FOLFIRI in terms of the progression-free survival (PFS), response rate (RR), and overall survival (OS). Furthermore, the Tribe trial showed that the RR and PFS rates in patients who received bevacizumab (Bmab)+FOLFOXIRI were superior to those in patients treated with Bmab+FOLFIRI. A phase III trial of panitumumab (Pmab)+FOLFOXIRI is currently ongoing. A modified FOLFOXIRI regimen is also widely used to reduce adverse events. In our department, we introduced modified FOLFOXIRI+α (mFOLFOXIRI+α) in 2015. The present study reviewed the efficacy and safety of mFOLFOXIRI+α. METHODS: Eligible patients were retrospectively reviewed, and their results were compared to those of patients treated with other regimens (OTHERS) (n=134) to demonstrate the efficacy of this treatment. Patients: Between February 2015 and November 2018, 12 patients with ARCC (male/female=6/6; average age, 60.7 years old) received mFOLFOXIRI+α (Bmab: 10, Pmab: 1, alone: 1). RESULTS: The median PFS in the mFOLFOXIRI+α and OTHERS groups was 565 and 322 days, respectively (p=0.0544). The RR in the mFOLFOXIRI+α and OTHERS groups was 66.7% and 31.3%, respectively (p=0.0135). The conversion rate (Conv R) in the mFOLFOXIRI+α and OTHERS groups was 50.0% and 12.7%, respectively (p=0.0007). While 58% of patients treated with FOLFOXIRI+α developed grade ≥3 leukopenia, the incidence of febrile neutropenia (FN) was only 17%. In all patients with symptoms due to the tumor burden, the symptoms subsided with mFOLFOXIRI+α treatment. CONCLUSION: Based on the RR, Conv R, and symptom palliation ability, mFOLFOXIRI+α was suggested to be a viable candidate for first-line treatment for patients with ARCC, especially those with a high tumor burden. |
format | Online Article Text |
id | pubmed-7303458 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | The Japanese Society of Internal Medicine |
record_format | MEDLINE/PubMed |
spelling | pubmed-73034582020-06-23 Efficacy and Safety of Modified FOLFOXIRI+α in the Treatment of Advanced and Recurrent Colorectal Cancer: A Single-center Experience Kobayashi, Kazuma Yamaguchi, Shun Ito, Shinichiro Torashima, Yasuhiro Inoue, Yusuke Okada, Satomi Enjoji, Takahiro Tetsuo, Hanako Kuba, Sayaka Kosaka, Taiichiro Adachi, Tomohiko Hidaka, Masaaki Yamanouchi, Kosho Kanetaka, Kengo Takatsuki, Mitsuhisa Eguchi, Susumu Intern Med Original Article OBJECTIVE: In the treatment of advanced and recurrent colorectal cancer (ARCC), FOLFOXIRI regimens have been proven to be significantly superior to FOLFIRI in terms of the progression-free survival (PFS), response rate (RR), and overall survival (OS). Furthermore, the Tribe trial showed that the RR and PFS rates in patients who received bevacizumab (Bmab)+FOLFOXIRI were superior to those in patients treated with Bmab+FOLFIRI. A phase III trial of panitumumab (Pmab)+FOLFOXIRI is currently ongoing. A modified FOLFOXIRI regimen is also widely used to reduce adverse events. In our department, we introduced modified FOLFOXIRI+α (mFOLFOXIRI+α) in 2015. The present study reviewed the efficacy and safety of mFOLFOXIRI+α. METHODS: Eligible patients were retrospectively reviewed, and their results were compared to those of patients treated with other regimens (OTHERS) (n=134) to demonstrate the efficacy of this treatment. Patients: Between February 2015 and November 2018, 12 patients with ARCC (male/female=6/6; average age, 60.7 years old) received mFOLFOXIRI+α (Bmab: 10, Pmab: 1, alone: 1). RESULTS: The median PFS in the mFOLFOXIRI+α and OTHERS groups was 565 and 322 days, respectively (p=0.0544). The RR in the mFOLFOXIRI+α and OTHERS groups was 66.7% and 31.3%, respectively (p=0.0135). The conversion rate (Conv R) in the mFOLFOXIRI+α and OTHERS groups was 50.0% and 12.7%, respectively (p=0.0007). While 58% of patients treated with FOLFOXIRI+α developed grade ≥3 leukopenia, the incidence of febrile neutropenia (FN) was only 17%. In all patients with symptoms due to the tumor burden, the symptoms subsided with mFOLFOXIRI+α treatment. CONCLUSION: Based on the RR, Conv R, and symptom palliation ability, mFOLFOXIRI+α was suggested to be a viable candidate for first-line treatment for patients with ARCC, especially those with a high tumor burden. The Japanese Society of Internal Medicine 2020-02-19 2020-05-15 /pmc/articles/PMC7303458/ /pubmed/32074573 http://dx.doi.org/10.2169/internalmedicine.3274-19 Text en Copyright © 2020 by The Japanese Society of Internal Medicine https://creativecommons.org/licenses/by-nc-nd/4.0/ The Internal Medicine is an Open Access journal distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view the details of this license, please visit (https://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Original Article Kobayashi, Kazuma Yamaguchi, Shun Ito, Shinichiro Torashima, Yasuhiro Inoue, Yusuke Okada, Satomi Enjoji, Takahiro Tetsuo, Hanako Kuba, Sayaka Kosaka, Taiichiro Adachi, Tomohiko Hidaka, Masaaki Yamanouchi, Kosho Kanetaka, Kengo Takatsuki, Mitsuhisa Eguchi, Susumu Efficacy and Safety of Modified FOLFOXIRI+α in the Treatment of Advanced and Recurrent Colorectal Cancer: A Single-center Experience |
title | Efficacy and Safety of Modified FOLFOXIRI+α in the Treatment of Advanced and Recurrent Colorectal Cancer: A Single-center Experience |
title_full | Efficacy and Safety of Modified FOLFOXIRI+α in the Treatment of Advanced and Recurrent Colorectal Cancer: A Single-center Experience |
title_fullStr | Efficacy and Safety of Modified FOLFOXIRI+α in the Treatment of Advanced and Recurrent Colorectal Cancer: A Single-center Experience |
title_full_unstemmed | Efficacy and Safety of Modified FOLFOXIRI+α in the Treatment of Advanced and Recurrent Colorectal Cancer: A Single-center Experience |
title_short | Efficacy and Safety of Modified FOLFOXIRI+α in the Treatment of Advanced and Recurrent Colorectal Cancer: A Single-center Experience |
title_sort | efficacy and safety of modified folfoxiri+α in the treatment of advanced and recurrent colorectal cancer: a single-center experience |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7303458/ https://www.ncbi.nlm.nih.gov/pubmed/32074573 http://dx.doi.org/10.2169/internalmedicine.3274-19 |
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