Modified FOLFOX6 with oxaliplatin stop-and-go strategy and oral S-1 maintenance therapy in advanced colorectal cancer: CCOG-0704 study
| Autor: | Takuya Watanabe, Naoki Iwata, Norifumi Ohashi, Chie Tanaka, Naoto Okuda, Hiroyuki Yokoyama, Goro Nakayama, Michitaka Fujiwara, Yasuhiro Kodera, Akimasa Nakao, Masahiko Koike |
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| Rok vydání: | 2011 |
| Předmět: |
Adult
Male Oncology medicine.medical_specialty Organoplatinum Compounds Colorectal cancer Leucovorin Administration Oral Tegafur Disease-Free Survival Maintenance therapy FOLFOX Surgical oncology Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans Neoplasm Metastasis Aged Neoplasm Staging business.industry Hematology General Medicine Middle Aged medicine.disease digestive system diseases Oxaliplatin Clinical trial Drug Combinations Oxonic Acid Fluorouracil Female Surgery Colorectal Neoplasms business medicine.drug |
| Zdroj: | International Journal of Clinical Oncology. 16:506-511 |
| ISSN: | 1437-7772 1341-9625 |
| DOI: | 10.1007/s10147-011-0214-6 |
| Popis: | A combination of fluorouracil and leucovorin (5-FU/LV) with oxaliplatin (FOLFOX) is an established first-line therapy for metastatic colorectal cancer (mCRC). However, the cumulative neurotoxicity of oxaliplatin often requires therapy to be discontinued while the patient is still responding. A strategy to stop FOLFOX, deliver 5-FU/LV as a maintenance therapy and reintroduce FOLFOX was found to be equivalent in terms of efficacy while neurotoxicity was substantially reduced. The aim of this study was to evaluate feasibility of a stop-and-go strategy with S-1, an oral fluoropyrimidine derivative, as a maintenance therapy administered between modified FOLFOX6 (mFOLFOX6) as a first-line treatment of mCRC.Thirty patients with untreated mCRC were treated with six cycles of mFOLFOX6 followed by maintenance therapy with oral S-1. Reintroduction of mFOLFOX6 was scheduled after four cycles of S-1 or upon tumor progression. The primary endpoint was duration of disease control (DDC).Twenty-one of the 30 patients who achieved responses or stabilizations received S-1 maintenance therapy. mFOLFOX6 was reintroduced in 15 patients. Median DDC and progression-free survival were 9.3 and 7.9 months, respectively. The response rates and disease control rates were 40.0 and 86.6% for the initial mFOLFOX6, 23.8 and 57.1% for S-1 maintenance therapy and 20.0 and 73.3% for mFOLFOX6 reintroduction, respectively. Twenty-eight patients (93.3%) had peripheral neuropathy, but grade 3 neurotoxicity was observed in only 1 patient (3.3%).The planned oxaliplatin stop-and-go strategy with oral S-1 maintenance therapy was feasible as a first-line treatment for Japanese mCRC patients. Further prospective randomized control study is warranted. |
| Databáze: | OpenAIRE |
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