Impact of irinotecan and oxaliplatin on overall survival in patients with metastatic colorectal cancer (MCRC): A population- based study

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 4077-4077 ◽  
Author(s):  
H. J. Lim ◽  
C. Fitzgerald ◽  
S. Gill ◽  
B. Melosky ◽  
C. Speers ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Metastatic Colorectal Cancer ◽  
Median Survival ◽  
Population Based ◽  
Population Based Study ◽  
Chemotherapy Agent ◽  
Kaplan Meier ◽  
Cancer Agency ◽  
One Year

4077 Background: Over the past 10 years, chemotherapeutic options for MCRC has significantly expanded from 5-FU based therapy, to include irinotecan and oxaliplatin. The effect of the availability of these treatments on overall survival is evaluated among patients in 3 time cohorts referred to the British Columbia Cancer Agency (BCCA). Methods: Patients with newly diagnosed or relapsed metastatic colorectal cancer referred to the BCCA in 1995/96, 2000 and 2003/04 were included. In 1995/96, 5-FU was the only palliative chemotherapy agent available at BCCA and irinotecan and oxaliplatin were available in 2000 and 2003, respectively. A one year period was used for the irinotecan cohort to minimize overlap between groups. Overall survival estimates were generated using the Kaplan Meier method. Survival was calculated from time of diagnosis of distant metastatic disease to either death or last contact date. Results: Cohorts were generally similar, however, a significantly higher proportion of patients received chemotherapy in more recent eras ( Table 1 ). Only 25% of patients received both irinotecan and oxaliplatin in 2003/4 and only 10 % received biologic therapies. An improvement in median survival of 3.6 months was observed. The improvement in the treated subgroup was 4.2 months. Outcomes of patients untreated with chemotherapy were unchanged between cohorts. Conclusions: In this population based study, the proportion of patients with MCRC treated with chemotherapy significantly increased between 1995/6 and 2000/2003/4. Patients treated with chemotherapy experienced a 4.2 month increase in median survival in 2003/4 compared to 1995/6. Survival improvements were only significant in the time period when all three effective chemotherapies (5FU, irinotecan and oxaliplatin) were available. As bevacizumab was not available until 2006, its survival impact in this population is not yet known. [Table: see text] No significant financial relationships to disclose.

scholarly journals Effectiveness and Costs Associated to Adding Cetuximab or Bevacizumab to Chemotherapy as Initial Treatment in Metastatic Colorectal Cancer: Results from the Observational FABIO Project

Cancers ◽  
2020 ◽  
Vol 12 (4) ◽  
pp. 839 ◽  
Author(s):  
Matteo Franchi ◽  
Donatella Garau ◽  
Ursula Kirchmayer ◽  
Mirko Di Martino ◽  
Marilena Romero ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Metastatic Colorectal Cancer ◽  
Survival Time ◽  
Initial Treatment ◽  
Biological Therapy ◽  
Population Based ◽  
Study Cohort ◽  
Standard Chemotherapy ◽  
Kaplan Meier

Evidence available on the effectiveness and costs of biological therapies for the initial treatment of metastatic colorectal cancer (mCRC) is scarce and contrasting. We conducted a population-based cohort investigation for assessing overall survival and costs associated with their use in a real-world setting. Healthcare utilization databases were used to select patients newly diagnosed with mCRC between 2010 and 2016. Those initially treated with biological therapy (bevacizumab or cetuximab) added to chemotherapy were propensity-score-matched to those treated with standard chemotherapy alone, and were followed up to June 30th, 2018. Kaplan–Meier survival estimates, restricted mean survival time (RMST) and cumulative costs were compared between the two treatment arms. The study cohort included 1896 mCRC patients treated with biological therapy matched to 5678 patients treated with chemotherapy alone. Median overall survival was 21.8 and 20.2 months, respectively. After 84 months of follow-up, RMSTs were 30.9 and 31.9 months (p = 0.193), indicating no differences between the average survival time between treatment arms. Patients treated with biological therapy were associated with higher costs. Cumulative per capita costs were €59,663 and €44,399, respectively. In our study, first-line biological therapy did not improve long-term overall survival and was associated with higher costs as compared to standard chemotherapy.

scholarly journals Impact of Irinotecan and Oxaliplatin on Overall Survival in Patients With Metastatic Colorectal Cancer: A Population-Based Study

2009 ◽  
Vol 5 (4) ◽  
pp. 153-158 ◽  
Author(s):  
Howard J. Lim ◽  
Sharlene Gill ◽  
Caroline Speers ◽  
Barbara Melosky ◽  
Jeff Barnett ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Metastatic Colorectal Cancer ◽  
Population Based ◽  
Therapeutic Options ◽  
Population Based Study

A look at the temporal impact of advancements in therapeutic options in the last 10 years—from fluorouracil to irinotecan and oxaliplatin—on overall survival in a population-based cohort.

scholarly journals IMMEDIATE AND REMOTE RESULTS OF PALLIATIVE SURGERY IN PATIENTS WITH METASTATIC COLORECTAL CANCER

2017 ◽  
Vol 22 (1) ◽  
pp. 32-38
Author(s):  
E. P Kulikov ◽  
M. E Ryazantsev ◽  
N. I Verkin ◽  
E. Yu Golovkin ◽  
M. A Porvatova ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Postoperative Complications ◽  
Mortality Rate ◽  
Metastatic Colorectal Cancer ◽  
Median Survival ◽  
Postoperative Mortality ◽  
Colon Resection ◽  
High Rate ◽  
Morbidity Rate ◽  
One Year

The significance of the study is associated with the high level of the morbidity rate of colorectal cancer, generous amount of patients with the 4th stage and the necessity of the research of palliative surgical treatment. A retrospective analysis of 364 cases with metastatic colorectal cancer included 58 patients with palliative colon resection and 306 patients with bypass anastomosis and unloading stoma. Evaluated parameters are the frequency of postoperative complications, postoperative mortality rate, median survival and one-year survival. In the group of palliative resections the frequency of postoperative complications and postoperative mortality rate were 32.7% and 20.6%, in the group of symptomatic operations the same results were 12.1% and 8.8%. Median survival, one-year survival in the group of palliative resections are longer than in the group of symptomatic operations - 10.0 and 5.1 months, 37.0% and 18.3%, respectively (p < 0.05). However, after stratification of studied subgroups according to the sign of the presence or absence of post-operative chemotherapy the survival were shown to be higher in patients with chemotherapy and hardly depended on fact of the removal of the primary tumor. To our opinion the high rate of postoperative complications and the postoperative mortality rate after palliative resections of the colon can be corrected by more precise determination of indications to their performance in emergency surgery. The improvement in survival indices is associated with the execution of postoperative adjuvant chemotherapy.

scholarly journals Practice variation on hospital level in the systemic treatment of metastatic colorectal cancer in The Netherlands: a population-based study

2020 ◽  
Vol 59 (4) ◽  
pp. 395-403
Author(s):  
Lotte Keikes ◽  
Miriam Koopman ◽  
Martijn M. Stuiver ◽  
Valery E. P. P. Lemmens ◽  
Martijn G. H. van Oijen ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
The Netherlands ◽  
Metastatic Colorectal Cancer ◽  
Systemic Treatment ◽  
Population Based ◽  
Practice Variation ◽  
Hospital Level ◽  
Population Based Study

Differences in the management and survival of metastatic colorectal cancer in Europe. A population-based study

2021 ◽  
Author(s):  
Anne-Marie Bouvier ◽  
Valérie Jooste ◽  
Maria José Sanchez-Perez ◽  
Maria José Bento ◽  
Jessica Rocha Rodrigues ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Metastatic Colorectal Cancer ◽  
Population Based ◽  
Population Based Study

High- versus low-dose leucovorin in the modified FOLFOX6 regimen for first-line treatment of metastatic colorectal cancer

2016 ◽  
Vol 23 (3) ◽  
pp. 173-178 ◽  
Author(s):  
Jana Reynolds ◽  
April Chamberland-Tremblay ◽  
Jon D Herrington ◽  
Yolanda Munoz Maldonado ◽  
Lucas Wong
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Retrospective Study ◽  
Metastatic Colorectal Cancer ◽  
Median Survival ◽  
High Dose ◽  
Survival Times ◽  
First Line ◽  
Metastatic Site ◽  
Modified Folfox6

Background In response to the national leucovorin shortage in 2008, our institution adjusted the modified FOLFOX6 (leucovorin, fluorouracil, and oxaliplatin) protocol to utilize a lower dose of leucovorin (20 mg/m2). This adjustment was based on prospective studies suggesting that lower doses of leucovorin may be equally effective in other fluorouracil containing regimens. This retrospective study evaluates outcomes in metastatic colorectal cancer (mCRC) patients treated with low- (20 mg/m2) vs. high-dose (400 mg/m2) leucovorin in the FOLFOX6 regimen for mCRC. Methods This retrospective analysis included consecutive mCRC patients from 2004 to 2011 if they received at least one cycle of modified FOLFOX6 as first line therapy. Patients who received an initial leucovorin dose other than 20 mg/m2 or 400 mg/m2 on their first cycle were excluded. Patient characteristics included demographics, metastatic site at initial diagnosis, and treatment history including chemotherapy and surgery. Primary outcome was date of death or last contact. Cox proportional hazards regression analysis and Kaplan–Meier survival curves were utilized to evaluate the effect of leucovorin dose on overall survival. Log-rank tests were used to compare median survival times by dose group. Results Of the 93 mCRC patients who received first line modified FOLFOX6, leucovorin 400 mg/m2 was administered to 47 (51%) patients and 20 mg/m2 to 46 (49%) patients. There were no differences of baseline characteristics between the groups with exception of primary site of cancer ( p = 0.038). The overall survival time was 22.5 months (95% CI 16.6–29.6). The median survival time in the leucovorin 400 mg/m2 group was 23.1 months (95% CI 16.2–35.7) compared to leucovorin 20 mg/m2 which was 20.5 months (95% CI 14.2–34.2); p = 0.573. The median survival times in patients with one versus two or more sites with metastasis were statistically different (26.9 vs. 16.2 months, p = 0.009). Metastatic site removal or ablation showed differences in the median survival, 34.2 months (95% CI 20.8–50.9) vs. 16.6 months (95% CI 14.1–23.6) without metastatic disease removal ( p = 0.004). The odds of dying for patients with two metastatic sites was higher compared with the odds of those patients with one site, HR 1.8 (95% CI 1.08–3.0). Patients without metastatic site removal or ablation had higher odds of dying compared to those patients without this procedure, HR 0.47 (95% CI 0.27–0.81). Conclusion In this single center retrospective study, there was no difference in overall survival for mCRC patients treated with first line FOLFOX6 with low- vs. high-dose leucovorin.

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