1. 日本内科学会
- Author
-
Kengo Kanetaka, Tomohiko Adachi, Shun Yamaguchi, Yasuhiro Torashima, Taiichiro Kosaka, Kazuma Kobayashi, Kosho Yamanouchi, Yusuke Inoue, Sayaka Kuba, Satomi Okada, Hanako Tetsuo, Takahiro Enjoji, Masaaki Hidaka, Mitsuhisa Takatsuki, Susumu Eguchi, and Shinichiro Ito
- Subjects
Adult ,Male ,medicine.medical_specialty ,Bevacizumab ,Organoplatinum Compounds ,Colorectal cancer ,Leucovorin ,colorectal cancer ,mFOLFOXIRI+a ,030204 cardiovascular system & hematology ,Single Center ,Gastroenterology ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,Internal Medicine ,Medicine ,Panitumumab ,Humans ,mFOLFOXIRI+α ,Aged ,Neoplasm Staging ,Retrospective Studies ,FOLFOXIRI ,business.industry ,General Medicine ,Middle Aged ,medicine.disease ,Progression-Free Survival ,Regimen ,FOLFIRI ,030211 gastroenterology & hepatology ,Original Article ,Camptothecin ,Female ,Fluorouracil ,Neoplasm Recurrence, Local ,business ,Colorectal Neoplasms ,Febrile neutropenia ,tumor burden ,medicine.drug - Abstract
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+a (mFOLFOXIRI+a) in 2015. The present study reviewed the efficacy and safety of mFOLFOXIRI+a. 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+a (Bmab: 10, Pmab: 1, alone: 1). Results: The median PFS in the mFOLFOXIRI+a and OTHERS groups was 565 and 322 days, respectively (p=0.0544). The RR in the mFOLFOXIRI+a and OTHERS groups was 66.7% and 31.3%, respectively (p= 0.0135). The conversion rate (Conv R) in the mFOLFOXIRI+a and OTHERS groups was 50.0% and 12.7%, respectively (p=0.0007). While 58% of patients treated with FOLFOXIRI+a 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+a treatment. Conclusion: Based on the RR, Conv R, and symptom palliation ability, mFOLFOXIRI+a was suggested to be a viable candidate for first-line treatment for patients with ARCC, especially those with a high tumor burden., Internal medicine, 59(10), pp.1239-1245; 2020
- Published
- 2020