Bevacizumab +oral 5-fluorourasil versus intensive chemotherapy for the treatment of elderly patients with metastatic colorectal cancer

Aim: This study compared the efficacy and safety of Bmab+oral 5-Fluorourasil (Bmab+o-5-FU) including Bmab+Capecitabine (Cape) with that of intensive chemotherapy including L-OHP or CPT-11 for patients with metastatic colorectal cancer (mCRC).Methods: Between January 2006 and February 2017, 40 elderly (?70 years) chemotherapy-naive patients with mCRC (male/female=22/18; median age, 76.0 years) were retrospectively reviewed. The treatment regimens were Bmab+o-5-FU (n=19)and intensive regimens (n=21). Intensive regimens comprised 17 L-OHP and 4 CPT-11 doublet chemotherapies.Results: The median progression-free survival (PFS) with Bmab+o-5-FU and intensive regimens was 281 and 215 days, respectively. The median survival time with Bmab+o-5-FU and intensive regimens was 961 and 1,002 days, respectively. No significant differences were observed in the overall survival or PFS between Bmab+o-5-FU and the other regimens. The disease control rate was 94.7% with Bmab+o-5-FU and 81.0% with intensive regimens. The rate of grade ?3 hematologicaladverse events was 5.3% for Bmab+o-5-FU and 15.8% for intensive regimens.Conclusions: With its similar survival benefit to intensive regimens, high disease control rate and good feasibility, Bmab+o-5-FU seems a fine treatment choice for elderly mCRC patients

Bevacizumab +oral 5-fluorourasil versus intensive chemotherapy for the treatment of elderly patients with metastatic colorectal cancer

Aim: This study compared the efficacy and safety of Bmab+oral 5-Fluorourasil (Bmab+o-5-FU) including Bmab+Capecitabine (Cape) with that of intensive chemotherapy including L-OHP or CPT-11 for patients with metastatic colorectal cancer (mCRC). Methods: Between January 2006 and February 2017, 40 elderly (≥70 years) chemotherapy-naïve patients with mCRC (male/female=22/18; median age, 76.0 years) were retrospectively reviewed. The treatment regimens were Bmab+o-5-FU (n=19)and intensive regimens (n=21). Intensive regimens comprised 17 L-OHP and 4 CPT-11 doublet chemotherapies. Results: The median progression-free survival (PFS) with Bmab+o-5-FU and intensive regimens was 281 and 215 days, respectively. The median survival time with Bmab+o-5-FU and intensive regimens was 961 and 1,002 days, respectively. No significant differences were observed in the overall survival or PFS between Bmab+o-5-FU and the other regimens. The disease control rate was 94.7% with Bmab+o-5-FU and 81.0% with intensive regimens. The rate of grade ≥3 hematologicaladverse events was 5.3% for Bmab+o-5-FU and 15.8% for intensive regimens. Conclusions: With its similar survival benefit to intensive regimens, high disease control rate and good feasibility, Bmab+o-5-FU seems a fine treatment choice for elderly mCRC patients

Efficacy and Safety of Modified FOLFOXIRI+α in the Treatment of Advanced and Recurrent Colorectal Cancer: A Single-center Experience

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