scholarly journals The role of combined treatment of metastatic colorectal cancer in patients with liver metastases

2019 ◽  
Vol 30 ◽  
pp. iv55
Author(s):  
D. Gridnev ◽  
M. Trandofilov ◽  
A. Zhevelyuk ◽  
D. Islamova ◽  
V. Makarov ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Liver Metastases ◽  
Metastatic Colorectal Cancer ◽  
Combined Treatment

scholarly journals Combined treatment of patients with liver colorectal cancer metastases

2021 ◽  
Vol 26 (2) ◽  
pp. 120-128
Author(s):  
D. N. Kostromitsky ◽  
A. Y. Dobrodeev ◽  
S. G. Afanasyev ◽  
A. S. Tarasova
Keyword(s):  
Colorectal Cancer ◽  
Liver Metastases ◽  
Metastatic Colorectal Cancer ◽  
Anticancer Agents ◽  
Combined Treatment ◽  
Malignant Neoplasm ◽  
Standard Of Care ◽  
Distant Metastases ◽  
Colorectal Cancer Liver Metastases ◽  
Results Of Treatment

The literature review is devoted to the analysis of the main methods of treatment of patients with colorectal cancer liver metastases. The analysis of the clinical trials results over the past 10 years has been carried out. Colorectal cancer is the common malignant neoplasm. About 20% of patients have distant metastases in the diagnosing. Liver is the most frequent targeted organ, liver metastases are detected in 14,5% of patients with colorectal cancer. Despite the encouraging results of treatment of certain groups of patients with metastatic colorectal cancer, the treatment tactics for most patients is limited to palliative chemotherapy. In recent years, the survival of patients with metastatic colorectal cancer has significantly improved due to the success of systemic therapy. The median overall survival has reached for 2 years due to combination chemotherapy based on fluoropyrimidines, oxaliplatin, irinotecan in combination with monoclonal antibodies (bevacizumab, cetuximab and panitumumab). The optimal combination and sequence of using these anticancer agents in the treatment of metastatic colorectal cancer has not yet been determined. Surgery is the standard of care for this category of patients. At the same time, until nowdays there are no clear and generally accepted criteria for choosing the optimal volume of surgical intervention, prescribing first-line chemotherapy and using other methods of antitumor treatment.

Role of Adjuvant Therapy After Resection of Colorectal Cancer Liver Metastases

2010 ◽  
Vol 28 (13) ◽  
pp. 2300-2309 ◽  
Author(s):  
Derek G. Power ◽  
Nancy E. Kemeny
Keyword(s):  
Colorectal Cancer ◽  
Liver Resection ◽  
High Risk ◽  
Adjuvant Chemotherapy ◽  
Liver Metastases ◽  
Metastatic Colorectal Cancer ◽  
Adjuvant Treatment ◽  
Systemic Chemotherapy ◽  
Perioperative Therapy

Liver resection is the goal of treatment strategies for liver-confined metastatic colorectal cancer. However, after resection the majority of patients will experience recurrence. Chemotherapy seems to improve outcomes compared with surgery alone. We reviewed the data of the role of adjuvant chemotherapy after resection of liver- confined metastatic colorectal cancer. Optimal regimens and sequencing of chemotherapies when liver resection is an option are unclear. Some suggest that resectable liver metastases, in the absence of high-risk features, should begin with surgery and consideration given to adjuvant chemotherapy after surgery. If high-risk features are present, most physicians prefer a short course of systemic preoperative chemotherapy. Perioperative therapy and regional therapy with hepatic arterial infusion (HAI) both increase disease-free survival (DFS) when compared with surgery alone. In unresectable disease, consideration should be given to systemic chemotherapy with or without a biologic agent or HAI with systemic therapy. If the disease becomes resectable, adjuvant treatment should follow surgery. Adjuvant chemotherapy is usually FOLFOX, but HAI combined with systemic chemotherapy is also an option. The role of adjuvant treatment post-liver resection should not be viewed in isolation but rather in the context of prior treatment, surgical preference, and individual patient characteristics. Perioperative therapy and regional therapy have both shown an increase in DFS. Conducting randomized trials examining the role of adjuvant chemotherapy has been difficult because of rapidly changing chemotherapies.

The Role of Maintenance Therapy in Metastatic Colorectal Cancer

JAMA Oncology ◽  
2020 ◽  
Vol 6 (6) ◽  
pp. 937
Author(s):  
Zi-Xian Wang ◽  
Fei Liang ◽  
Rui-Hua Xu
Keyword(s):  
Colorectal Cancer ◽  
Maintenance Therapy ◽  
Metastatic Colorectal Cancer

LIver Resection and role of Extended Histology (LiREcH study) in patients with multifocal colorectal cancer liver metastases

HPB ◽  
2021 ◽  
Author(s):  
Hassaan Bari ◽  
Umasankar M. Thiyagarajan ◽  
Rachel Brown ◽  
Keith J. Roberts ◽  
Nikolaos Chatzizacharias ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Liver Resection ◽  
Liver Metastases ◽  
Colorectal Cancer Liver Metastases

Regorafenib plus PD-1 inhibitors in Chinese patients with microsatellite stable/mismatch repair proficient metastatic colorectal cancer: A real-world study.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e15585-e15585
Author(s):  
Kaili Yang ◽  
Lu Han ◽  
Yun-Bo Zhao ◽  
Yang Ge ◽  
Qin LI ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Liver Metastases ◽  
Disease Control ◽  
Metastatic Colorectal Cancer ◽  
Mismatch Repair ◽  
Real World ◽  
Objective Response ◽  
Disease Control Rate ◽  
Chinese Patients ◽  
Hand Foot Syndrome

e15585 Background: A previous phase 1b trial has shown encouraging efficacy of regorafenib plus nivolumab in patients with microsatellite stable/mismatch repair proficient (MSS/pMMR) metastatic colorectal cancer (mCRC). We aimed to evaluate the efficacy and safety of this regimen in Chinese patients in the real world. Methods: We retrospectively identified patients with MSS/pMMR mCRC who received at least one dose of programmed cell death-1 (PD-1) inhibitors plus regorafenib from 5/2019 to 2/2021 in 10 Chinese medical centers. The primary endpoint was overall survival (OS). Secondary endpoints included progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR) and the safety. Results: Fifty-two patients were identified. Liver metastases were presented in 35 patients (67%). A total of 48 patients (92%) received regorafenib plus a PD-1 inhibitor as the third or later line treatment. At the data cut-off, 11 patients (21%) were still on treatment. Other patients terminated treatment because of progressive disease (45%), treatment-related adverse events (TRAEs) (14%) or treatment-unrelated deaths (6%). The median treatment cycle was 3 (range, 1-18). At a median follow-up of 4.9 months, the median OS was 17.3 months (95% CI, 10.2-NR) and the median PFS was 3.1 months (95%CI, 2.5-6.0). Baseline liver metastases were associated with inferior PFS (2.7 versus 6.3 months, p <0.05), but not OS (17.3 months versus NR, p =0.6). Among 38 patients evaluable for response, two patients (5%) achieved partial response, and 17 patients (45%) experienced stable disease as the best response. The DCR was 50% (95%CI, 5.0-NR) and was similar among different PD-1 inhibitors (Table). TRAEs were observed in 30 patients (58%). Fatigue (21%), hand-foot syndrome (19%) and rash (13%) were the most common TRAEs. Eight patients (15%) experienced grade 3-4 TRAEs, including rash (n=3), hand-foot syndrome (n=2), hypertension (n=1), myocardial enzyme elevation (n=1) and visual field loss (n=1). No treatment-related death occurred. Conclusions: The combination of regorafenib plus PD-1 inhibitors was generally tolerated and exhibited potential benefit in terms of OS and DCR. The presence of baseline liver metastases was predictive for shorter PFS but requires further investigation. Disease control rate of different PD-1 inhibitors.[Table: see text]

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