AIM: To evaluate the efficacy and safety of the FOLFIRI regimen in patients with metastatic pancreatic adenocarcinoma (PAC) after the failure of gemcitabine and platinum salts. METHODS: All consecutive patients with h...AIM: To evaluate the efficacy and safety of the FOLFIRI regimen in patients with metastatic pancreatic adenocarcinoma (PAC) after the failure of gemcitabine and platinum salts. METHODS: All consecutive patients with histologically confirmed, metastatic PAC and World Health Organiza-tion performance status (PS) ≤ 2 received FOLFIRI-1 [irinotecan 180 mg/m2 on day 1 and leucovorin 400 mg/m2 followed by 5-fluorouracil (5-FU) 400 mg/m2 bolus, then 5-FU 2400 mg/m2 as a 46-h infusion, biweekly] or FOLFIRI-3 (irinotecan 100 mg/m2 on day 1 and leucovorin 400 mg/m2, then 5-FU 2400 mg/m2 as a 46-h infusion and irinotecan 100 mg/m2 repeated on day 3, biweekly) after failure of gemcitabine and platinum-based chemotherapies as a systematic policy in two institutions between January 2005 and May 2010. Tumor response, time to progression (TTP), overall survival rate (OS) and grade 3-4 toxicities were retrospectively studied. Subgroup analyses were performed to search for prognostic factors. RESULTS: Sixty-three patients (52.4% male, median age 59 years) were analyzed. Among them, 42.9% were PS 0, 38.1% were PS 1 and 19.0% were PS 2. Fifty one patients (81.0%) had liver metastases. Before the FOLFIRI regimen, patients had received 1 line (n = 19), 2 lines (n = 39) or 3 lines (n = 5) of chemotherapy. Median TTP obtained with the line before FOLFIRI was 3.9 mo (95% CI: 3.4-5.3 mo). A total of 480 cycles was completed (median: 6 cycles, range: 1-51 cycles). The main reason for discontinuing FOLFIRI was tumor progression (90.3%). Tumor control was achieved in 25 patients (39.7%) (partial response: n = 5, stable disease: n = 20) with FOLFIRI. Median TTP was 3.0 mo (95% CI: 2.1-3.9 mo) and median OS was 6.6 mo (95% CI: 5.3-8.1 mo). Dose adaptation was required in 36 patients (57.1%). Fifteen patients (23.8%) had grade 3-4 toxicities, mainly hematological (n = 11) or digestive (n = 4). Febrile neutropenia occurred in 3 patients. There was no toxic death. PS 2 was significantly associated with poor TTP [hazard ratio (HR): 16.036, P < 0.0001] and OS (HR: 4.003, P = 0.004). CONCLUSION: The FOLFIRI regimen had an acceptable toxicity and an interesting efficacy in our study, limited to patients in good condition (PS 0-1).展开更多
The study was designed to evaluate the therapeutic and side effects of Bevacizumab plus FOLFIRI regimen as front-line therapy for Chinese patients with advanced colorectal cancer. A total of 15 previously untreated pa...The study was designed to evaluate the therapeutic and side effects of Bevacizumab plus FOLFIRI regimen as front-line therapy for Chinese patients with advanced colorectal cancer. A total of 15 previously untreated patients with advanced colorectal cancer received Bevacizumab plus FOLFIRI regimen as font-line therapy, in detail, irinotecan 180 mg/m2 was given intravenously on day1, then calcium folinate (CF) 200 mg/m2, F-fluorouracil (5-Fu) 400 mg/m2 given in bolus immediately after CF, day 1 - 2;5-Fu 600 mg/2 given continuously after bolus for 22 hours on day1, day2;Bevacizumab was given intravenously at dosage of 5 mg/kg, on day-1. Therapeutic and side effects were evaluated at least after four cycles of treatment. The results showed that all the cases among the group were valid for response evaluation, with CR 0, PR 10, SD 3, and PD 2. The response rate is 66.7% and median time to progression (mTTP) was 10.6 months. The main toxicities were bone marrow suppression, nausea and vomiting, stomach pain and diarrhea;there was no chemotherapy-related death. The data suggested that the combination regimen with Bevacizumab plus FOLFIRI regimen was effective as front-line therapy for Chinese patients with advanced colorectal cancer, and the side effects were tolerable and manageable.展开更多
文摘AIM: To evaluate the efficacy and safety of the FOLFIRI regimen in patients with metastatic pancreatic adenocarcinoma (PAC) after the failure of gemcitabine and platinum salts. METHODS: All consecutive patients with histologically confirmed, metastatic PAC and World Health Organiza-tion performance status (PS) ≤ 2 received FOLFIRI-1 [irinotecan 180 mg/m2 on day 1 and leucovorin 400 mg/m2 followed by 5-fluorouracil (5-FU) 400 mg/m2 bolus, then 5-FU 2400 mg/m2 as a 46-h infusion, biweekly] or FOLFIRI-3 (irinotecan 100 mg/m2 on day 1 and leucovorin 400 mg/m2, then 5-FU 2400 mg/m2 as a 46-h infusion and irinotecan 100 mg/m2 repeated on day 3, biweekly) after failure of gemcitabine and platinum-based chemotherapies as a systematic policy in two institutions between January 2005 and May 2010. Tumor response, time to progression (TTP), overall survival rate (OS) and grade 3-4 toxicities were retrospectively studied. Subgroup analyses were performed to search for prognostic factors. RESULTS: Sixty-three patients (52.4% male, median age 59 years) were analyzed. Among them, 42.9% were PS 0, 38.1% were PS 1 and 19.0% were PS 2. Fifty one patients (81.0%) had liver metastases. Before the FOLFIRI regimen, patients had received 1 line (n = 19), 2 lines (n = 39) or 3 lines (n = 5) of chemotherapy. Median TTP obtained with the line before FOLFIRI was 3.9 mo (95% CI: 3.4-5.3 mo). A total of 480 cycles was completed (median: 6 cycles, range: 1-51 cycles). The main reason for discontinuing FOLFIRI was tumor progression (90.3%). Tumor control was achieved in 25 patients (39.7%) (partial response: n = 5, stable disease: n = 20) with FOLFIRI. Median TTP was 3.0 mo (95% CI: 2.1-3.9 mo) and median OS was 6.6 mo (95% CI: 5.3-8.1 mo). Dose adaptation was required in 36 patients (57.1%). Fifteen patients (23.8%) had grade 3-4 toxicities, mainly hematological (n = 11) or digestive (n = 4). Febrile neutropenia occurred in 3 patients. There was no toxic death. PS 2 was significantly associated with poor TTP [hazard ratio (HR): 16.036, P < 0.0001] and OS (HR: 4.003, P = 0.004). CONCLUSION: The FOLFIRI regimen had an acceptable toxicity and an interesting efficacy in our study, limited to patients in good condition (PS 0-1).
文摘The study was designed to evaluate the therapeutic and side effects of Bevacizumab plus FOLFIRI regimen as front-line therapy for Chinese patients with advanced colorectal cancer. A total of 15 previously untreated patients with advanced colorectal cancer received Bevacizumab plus FOLFIRI regimen as font-line therapy, in detail, irinotecan 180 mg/m2 was given intravenously on day1, then calcium folinate (CF) 200 mg/m2, F-fluorouracil (5-Fu) 400 mg/m2 given in bolus immediately after CF, day 1 - 2;5-Fu 600 mg/2 given continuously after bolus for 22 hours on day1, day2;Bevacizumab was given intravenously at dosage of 5 mg/kg, on day-1. Therapeutic and side effects were evaluated at least after four cycles of treatment. The results showed that all the cases among the group were valid for response evaluation, with CR 0, PR 10, SD 3, and PD 2. The response rate is 66.7% and median time to progression (mTTP) was 10.6 months. The main toxicities were bone marrow suppression, nausea and vomiting, stomach pain and diarrhea;there was no chemotherapy-related death. The data suggested that the combination regimen with Bevacizumab plus FOLFIRI regimen was effective as front-line therapy for Chinese patients with advanced colorectal cancer, and the side effects were tolerable and manageable.
