Abstract
To highlight the potential factors that could predict the response rate of patients with metastatic colorectal cancer (mCRC) treated with pemetrexed combined chemotherapy after first- or second-line chemotherapy using the FOLFOX regimen. Between January 2007 and July 2014, 54 patients diagnosed and pathologically-confirmed with advanced colorectal cancer in Jiangsu Cancer Hospital and Research Institute, were enrolled. They received pemetrexed at a dose of 500mg/m2 by 10 minute infusion on day 1, repeated every 3 weeks. Doses were modified depending on nadir counts of blood cells. Combined chemotherapeutic agents included irinotecan, lobaplatin, carboplatin, oxaliplatin, gemcitabine, cis-platinum or bevacizumab. Multiple variables (age, sex, hemoglobin, platinum drugs combined, metastasis sites, LDH, ALP, CEA>40 ug/ml) reported earlier were selected.We used logistic regression analysis to evaluate relationships between these and tumor response. On multivariable analysis, we found that age was significant in predicting the responsiveness to pemetrexed (p<0.05) combined with oxaliplatin. We did not find any other factors which were significantly associated with the response rate to chemotherapy with pemetrexed and irinotecan. By multivariate analysis, we found that age had significant impact on the responsiveness of pemetrexed when combined with oxaliplatin. Additional research based on genomic properties of host and tumors are needed to clarify markers for better selection of patients who could benefit from pemetrexed combined chemotherapy.
Highlights
Colorectal cancer is the third most commonly cancer in males and the second in females, with over 1.2 million new cancer cases and 608, 700 deaths estimated to occurred in 2008 (Jemal et al, 2011)
On multivariable analysis, we found that age was significant in predicting the responsiveness to pemetrexed (p
We did not find any other factors which were significantly associated with the response rate to chemotherapy with pemetrexed and irinotecan
Summary
Colorectal cancer is the third most commonly cancer in males and the second in females, with over 1.2 million new cancer cases and 608, 700 deaths estimated to occurred in 2008 (Jemal et al, 2011). Disease is too advanced and only palliative therapy could be considered Doublets such as irinotecan plus infusional 5-FU/LV (FOLFIRI) or oxaliplatin plus infusional 5-FU/LV (FOLFOX) prolonged median survival to more than 20 months (de Gramont et al, 2000; Douillard et al, 2000; Goldberg et al, 2004; Kohne et al, 2005). Many patients still failed to treatment due to tumor recurrence and metastasis, and 5-year survival rate still less than 10%. The objective responses rates were 15% in one study (John et al, 2000) and 17% in another (Cripps et al, 1999) and the median overall survival time was 16.2 and 15.1 months, respectively. We designed this study and tried to identify independent factors that could predict the responsiveness of pemetrexed in treating patients with advanced colorectal
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