FOLFIRI plus bevacizumab as a second-line therapy for metastatic intrahepatic cholangiocarcinoma

AIM:To evaluate the efficacy and tolerance of FOLFIRI plus bevacizumab treatment outcome as second-line treatment for metastatic intrahepatic cholangiocarcinoma.METHODS:Thirteen consecutive patients with metastatic intrahepatic cholangiocarcinoma who were refractory tofirst-line therapy consisting of gemcitabine plus oxaliplatinbased first-line chemotherapy given intravenously via intra-arterial infusion were treated with FOLFIRI[irinotecan(180 mg/m2 i.v.over 90 min)concurrently with folinic acid(400 mg/m2 i.v.over 120 min)followed by fluorouracil(400 mg/m2 i.v.bolus)then fluorouracil 2400 mg/m2 intravenous infusion over 46 h]and bevacizumab(5mg/kg)every 2 wk.Tumor response was evaluated by computed tomography scan every 4 cycles.RESULTS:The best tumor responses using response evaluation criteria in solid tumor criteria were:complete response for 1 patient,partial response for 4 patients,and stable disease for 6 patients after 6 mo of follow-up.The response rate was 38.4%(95%CI:12.5-89)and the disease control rate was 84.5%(95%CI:42-100).Seven deaths occurred at the time of analysis,progression free survival was 8 mo(95%CI:7-16),and median overall survival was 20 mo(95%CI:8-48).No grade 4toxic events were observed.Four grade 3 hematological toxicities and one grade 3 digestive toxicity occurred.An adaptive reduction in chemotherapy dosage was required in 2 patients due to hematological toxicity,and a delay in chemotherapy cycles was required for 3 patients.CONCLUSION:FOLFIRI plus bevacizumab combination treatment showed promising efficacy and safety as second-line treatment for metastatic intrahepatic cholangiocarcinoma after failure of the first-line treatment of gemcitabine plus oxaliplatin chemotherapy.

Safety and efficacy of a docetaxel-5FU-oxaliplatin regimen with or without trastuzumab in neoadjuvant treatment of localized gastric or gastroesophageal junction cancer: A retrospective study

BACKGROUND Triplet chemotherapy,with docetaxel-5FU-oxaliplatin FLOT regimen recently became the standard perioperative treatment for localized gastric cancer(GC).An adapted regimen called TeFOX was recently tested in metastatic setting and gave promising results.AIM To determine safety and efficacy of TeFOX perioperative regimen.METHODS This monocentric retrospective study aims to test efficacy and safety of the perioperative TeFOX regimen given alone or in combination with trastuzumab in patients with localized GC.TeFOX consist in docetaxel(50 mg/m^2)with oxaliplatin 85 mg/m^2 and and leucovorin(400mg/m^2^)5 FU bolus(400mg/m^2)on day 1,followed by continuous infusion of 5FU for 46h(2400mg/m^2)every 2 wk.RESULTS Thirty-three consecutive patients were included in this retrospective study.Eighteen patients have a gastroesophageal junction cancer and 11 have a GC.Median follow-up of surviving patients was 32 mo.R0 resection was obtained in 30(91)patients.Twelve patients(36)had a pathological complete response and 8(24)patients a nearly complete pathological response.Median OS and PFS were not reached at data base lock.We have observed 6 metastatic relapses and 1 localized relapse.No relapse was observed in patients with pathological complete responses.The most common grade 3-4 adverse events were peripheral neuropathy(21)and asthenia(20).CONCLUSION TeFOX regimen could be safely administrated in perioperative treatment of localized GC.TeFOX and the FLOT regimen have comparable efficacy and safety profiles.