Background: This study evaluated the tolerability and efficacy of intermittent oxaliplatin treatment based on mFOLFOX6 using oral uracil-tegafur(UFT) and leucovorin(LV) maintenance therapy in the treatment of elderly ...Background: This study evaluated the tolerability and efficacy of intermittent oxaliplatin treatment based on mFOLFOX6 using oral uracil-tegafur(UFT) and leucovorin(LV) maintenance therapy in the treatment of elderly patients with advanced colorectal cancer. Methods: Ten non-elderly patients (70 years) with advanced/recurrent colorectal cancer were enrolled in this prospective, multicenter cooperative group clinical trial. The mFOLFOX6 regimen was administered for eight cycles with maintenance therapy with oral UFT/LV treatment until progression. In cases with disease progression, mFOLFOX6 was reintroduced. Results: Grade 2 peripheral neuropathy was noted in 30.0% and 25.0% of the elderly and non-elderly patients, respectively. The observed time to treatment failure (TTF) was 6.3 months in the elderly patients and 6.4 months in the non-elderly patients. The disease control rate was 83.3% in each group. Conclusion: Our new stop-and-go strategy using oral UFT/LV is well-tolerated and effective even in elderly patients.展开更多
Background: Molecular targeted agents, such as bevacizumab and cetuximab, have been shown to improve the overall survival of metastatic colorectal cancer (mCRC) patients. However, we still do not know the best sequenc...Background: Molecular targeted agents, such as bevacizumab and cetuximab, have been shown to improve the overall survival of metastatic colorectal cancer (mCRC) patients. However, we still do not know the best sequence in which to use the molecular targeted agents for mCRC, especially in K-ras wild-type cases. Methods: From July 2006 to November 2010, 63 chemotherapy-naive patients who were diagnosed with mCRC and received an oxaliplatin-based regimen as the first line, did not respond to a bevacizumab-containing regimen used as the first or second line, and received cetuximab or continued bevacizumab, were eligible for this analysis. Thirty-two patients received cetuximab as the third or fourth line chemotherapy due to the K-ras wild-type (Group A). Also, thirty-one patients continued a bevacizumab-containing regimen in spite of disease progression (Group B). Results: The difference in the rate of serious adverse events was not significant between the two groups, but the rate of overall adverse events tended to be higher in Group A than in Group B. The median overall survival (MST) was significantly higher in Group A than Group B (30.8 months and 23.13 months (95%CI: 15.80 - 30.47), respectively) (P = 0.031). Group A patients were all K-ras wild-type, and 21 of Group B were K-ras mutant type. Compared with Group B patients with the K-ras mutant type, MST of Group A patients was significantly longer (30.8 months and 25.73 months, respectively) (P = 0.025). Conclusion: Using cetuximab after progression with bevacizumab might be an effective sequence to improve the overall survival of K-ras wild-type mCRC patients. However, we need further prospective studies to identify the best sequence of chemotherapy for mCRC patients.展开更多
文摘Background: This study evaluated the tolerability and efficacy of intermittent oxaliplatin treatment based on mFOLFOX6 using oral uracil-tegafur(UFT) and leucovorin(LV) maintenance therapy in the treatment of elderly patients with advanced colorectal cancer. Methods: Ten non-elderly patients (70 years) with advanced/recurrent colorectal cancer were enrolled in this prospective, multicenter cooperative group clinical trial. The mFOLFOX6 regimen was administered for eight cycles with maintenance therapy with oral UFT/LV treatment until progression. In cases with disease progression, mFOLFOX6 was reintroduced. Results: Grade 2 peripheral neuropathy was noted in 30.0% and 25.0% of the elderly and non-elderly patients, respectively. The observed time to treatment failure (TTF) was 6.3 months in the elderly patients and 6.4 months in the non-elderly patients. The disease control rate was 83.3% in each group. Conclusion: Our new stop-and-go strategy using oral UFT/LV is well-tolerated and effective even in elderly patients.
文摘Background: Molecular targeted agents, such as bevacizumab and cetuximab, have been shown to improve the overall survival of metastatic colorectal cancer (mCRC) patients. However, we still do not know the best sequence in which to use the molecular targeted agents for mCRC, especially in K-ras wild-type cases. Methods: From July 2006 to November 2010, 63 chemotherapy-naive patients who were diagnosed with mCRC and received an oxaliplatin-based regimen as the first line, did not respond to a bevacizumab-containing regimen used as the first or second line, and received cetuximab or continued bevacizumab, were eligible for this analysis. Thirty-two patients received cetuximab as the third or fourth line chemotherapy due to the K-ras wild-type (Group A). Also, thirty-one patients continued a bevacizumab-containing regimen in spite of disease progression (Group B). Results: The difference in the rate of serious adverse events was not significant between the two groups, but the rate of overall adverse events tended to be higher in Group A than in Group B. The median overall survival (MST) was significantly higher in Group A than Group B (30.8 months and 23.13 months (95%CI: 15.80 - 30.47), respectively) (P = 0.031). Group A patients were all K-ras wild-type, and 21 of Group B were K-ras mutant type. Compared with Group B patients with the K-ras mutant type, MST of Group A patients was significantly longer (30.8 months and 25.73 months, respectively) (P = 0.025). Conclusion: Using cetuximab after progression with bevacizumab might be an effective sequence to improve the overall survival of K-ras wild-type mCRC patients. However, we need further prospective studies to identify the best sequence of chemotherapy for mCRC patients.
