Second-line treatment with oxaliplatin + raltitrexed in patients with advanced colorectal cancer failing fluoropyrimidine/leucovorin-based chemotherapy

624 Background: New strategies are needed to improve outcomes and reduced toxicities of currently treatments for patients with advanced colorectal cancer. Nowadays maintaining treatment until disease progression is the standard option for these patients. Cetuximab is a recombinant humanized monoclonal antibody that neutralizes epidermal growth factor receptor and it has shown benefit not only in combination with standard chemotherapy in first- and second-line treatment or as a single agent in progression to standard chemotherapy in KRAS wild-type metastatic colorectal cancer (mCRC). Methods: This data describes patients who received standard chemotherapy with cetuximab every two weeks. For patients with response or stable disease, cetuximab was continued until disease progression or unacceptable toxicity. Results: Twelve patients are reported, nine were male (75%). The median age was 62 years (range, 46 to 78 years). All patients had stage IV, and liver was the most common location (75%). The majority of patients (75%) received FOLFOX VI as a first-line treatment in combination with cetuximab; only two patients were treated with FOLFIRI. Cetuximab was maintained after the first line of treatment in the 75% of patients. The median of cycles of chemotherapy and cetuximab was 12. Best response achieved in this setting was complete response (58.3%, 7/12). Median of monotherapy with cetuximab treatment was 7.5 cycles (range 3 to 12). At the moment of this analysis seven of twelve patients continued with the maintenance. In the rest of patients the treatment was followed until progression (33%, 3/12). No grade 3-4 toxicities were seen during maintenance cetuximab. The most common adverse effect during maintenance was cutaneous toxicity but the majority of patients had minor toxicity (50% grade 1). Conclusions: Cetuximab has significant antitumor activity not only as a single agent or in combination with standard chemotherapy but may also when it is used as maintenance therapy after a complete or partial response to first or second line based chemotherapy in mCRC. Maintenance cetuximab is feasible, safe, and worthy of future study in advanced colorectal cancer. No significant financial relationships to disclose.

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237 A phase I study of irinotecan (CPT-11) and capecitabina (XL) as second line treatment in advanced colorectal cancer

European Journal of Cancer Supplements ◽

10.1016/s1359-6349(03)90270-9 ◽

2003 ◽

Vol 1 (5) ◽

pp. S73 ◽

Cited By ~ 1

Author(s):

P. Garcia-Alfonso ◽

A. Munoz ◽

M. Méndez ◽

S. Garcia-Adrian ◽

P. Lopez-Criado ◽

...

Keyword(s):

Colorectal Cancer ◽

Phase I ◽

Phase I Study ◽

Advanced Colorectal Cancer ◽

Line Treatment ◽

Second Line

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Irinotecan and Oxaliplatin Combination, As Second-Line Treatment, In Fluoropyrimidine-Pretreated Advanced Colorectal Cancer. A Phase Ii Study by the Hellenic Cooperative Oncology Group (Hecog)

Tumori Journal ◽

10.1177/030089160509100404 ◽

2005 ◽

Vol 91 (4) ◽

pp. 309-313 ◽

Cited By ~ 6

Author(s):

Eleni Timotheadou ◽

Pavlos Papakostas ◽

Dimitrios Tsavdaridis ◽

George Basdanis ◽

Haralambos Kalofonos ◽

...

Keyword(s):

Colorectal Cancer ◽

Advanced Colorectal Cancer ◽

Performance Status ◽

Line Treatment ◽

Second Line ◽

Time To Progression ◽

Common Grade ◽

Disease Stabilization ◽

Multiple Liver Metastases ◽

Modest Activity

Background The management of patients with fluoropyrimidine-resistant advanced colorectal cancer remains investigational. Irinotecan and oxaliplatin have proved effective in first-line treatment in combination with 5-fluorouracil. Study design From February 1998 to September 2002, 34 patients with 5-fluorouracil-pretreated advanced colorectal cancer were enrolled in the study. Median age was 67 years (range, 32–76) and median performance status was 1. Twenty-one patients had multiple liver metastases. Other sites of disease included lungs, abdomen, pelvis, lymph nodes, bones and skin. They received six 28-day cycles of oxaliplatin (85 mg/m2 in a 2-h infusion on days 1 and 15) and irinotecan (80 mg/m2 in a 30-minute infusion on days 1,8 and 15 immediately following oxaliplatin). Results Thirteen patients (39%) completed treatment. The most common grade III-IV toxicities were diarrhea (27%), anemia (6%), neutropenia (18%), alopecia (6%) and peripheral neuropathy (6%). Thirteen patients (39%) received G-CSF support, and there were 2 episodes of febrile neutropenia. There were no treatment-related deaths. Six patients (18%) had a partial remission and another 11 (33%), disease stabilization. There were no complete remissions. Median time to progression was 6.6 months (range, 0.8–20.1) and median survival 10.6 months (range, 0.8–52.9). Conclusions Irinotecan and oxaliplatin combination has modest activity as second line treatment of 5-fluorouracil-resistant advanced colorectal cancer. Further research is warranted for the development of more effective and less toxic regimens in this setting.

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