Abstract
BackgroundThe aim of this study was to evaluate the efficacy and safety of first-line chemotherapy with re-introduction of oxaliplatin (OX) more than 6 months after adjuvant chemotherapy including OX.MethodsStage II/III colon cancer patients with neuropathies of grade ≤ 1 who relapsed more than 6 months after adjuvant chemotherapy including OX were considered eligible. Eligible patients were treated with 5-fluorouracil, l-leucovorin and OX plus molecularly targeted agents or capecitabine and OX plus bevacizumab (BV) or S-1 and OX plus BV. The primary endpoint was the progression-free survival (PFS), and the secondary endpoints were the overall survival (OS), response rate (RR) and toxicity.ResultsA total of 50 patients were enrolled between September 2013 and May 2019. Twelve patients received 5-fluorouracil, l-leucovorin and OX (FOLFOX) plus BV, 21 patients received capecitabine and OX plus BV, 10 patients received S-1 and OX plus BV and 7 patients received FOLFOX plus cetuximab or panitumumab. The median PFS was 11.5 months (95% confidence interval [CI] 8.3–16.0), the median OS was 45.4 months (95% CI 37.4–NA), and the RR was 56.0% (95% CI 42.3–68.8). Adverse events of grade ≥ 3 that occurred in ≥ 5% of cases were neutropenia in 6 patients (12%), peripheral sensory neuropathy in 5 patients (10%), diarrhea in 4 patients (8%), hypertension in 4 patients (8%), anorexia in 3 patients (6%) and allergic reactions in 3 patients (6%).ConclusionsFirst-line chemotherapy with re-introduction of OX more than 6 months after adjuvant chemotherapy including OX can be used safely with expected efficacy for relapsed colon cancer patients.
Highlights
Inclusion and exclusion criteriaColon cancer is the third-most commonly diagnosed cancer, with an estimated 1,400,000 new cases and 700,000 deaths globally each year [1]
The present study evaluated the efficacy and safety of firstline chemotherapy with re-introduction of OX more than six months after the completion of adjuvant chemotherapy including OX
Our findings suggested that first-line chemotherapy with re-introduction of OX more than 6 months after adjuvant chemotherapy including OX could be used safely with the expected efficacy for relapsed colon cancer patients
Summary
Inclusion and exclusion criteriaColon cancer is the third-most commonly diagnosed cancer, with an estimated 1,400,000 new cases and 700,000 deaths globally each year [1]. Three pivotal studies have shown that OX-based adjuvant chemotherapy, such as infusional 5-fluorouracil, l-leucovorin and OX (FOLFOX) or capecitabine and OX (CAPOX), for colon cancer significantly improved both the overall survival (OS) and disease-free survival [5,6,7]. There is little supporting evidence available, and few studies have evaluated the efficacy and safety of OX re-introduction as the first-line treatment for relapsed colon cancer after OX-based adjuvant chemotherapy [11, 12]. Methods Stage II/III colon cancer patients with neuropathies of grade ≤ 1 who relapsed more than 6 months after adjuvant chemotherapy including OX were considered eligible. Conclusions First-line chemotherapy with re-introduction of OX more than 6 months after adjuvant chemotherapy including OX can be used safely with expected efficacy for relapsed colon cancer patients
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