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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...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japanese Society of Internal Medicine 2020
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.
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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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