Abstract
e14109 Background: Tumor angiogenesis is one of the factors contributing to the growth and metastasis. In addition, it is a possible mechanism for repopulation of cells between cycles of standard chemotherapy, which leads to low efficiency of drug treatment in terms of overall survival. Therefore, inhibition of angiogenesis is a promising option of therapy for patients with metastatic disease. Methods: We conducted a phase II study of metronomic CPT-11 2.8 mg/m2/daily C.I. for 24 hours. There was no limit on the number of prior therapies. CT scans were performed every 6 weeks. Patients were treated until tumor progression or development of unacceptable toxicity. Serum was collected for measurement of endothelial progenitor cells (CD45-, CD105+, CD34+, CD59+, CD80+, CD86+). Results: 20 patients (pts) with MCRC were enrolled (12 female, 8 male), 17 of them were evaluated. Median age was 57.5 years (range 32-73). 6 (32.5%) pts had ECOG 2 and more. 60% of pts had 3 or more and 40% at least 2 prior chemotherapy lines. Toxicities included allergic reaction (1 G3), nausea (5 G1), vomiting (1 G1), diarrhea (3 G1), fatigue (1 G1), fever (1 G1), alopecia (1 G1). There were no treatment related deaths. There were no CR or PR. 9 of 17 pts had SD (53%). Median progression-free survival (PFS) was 103 (range 90-107) and 110 days (range 50-239) for 2nd and 3d lines chemotherapy, accordingly. The level of endothelial progenitor cells decreased with metronomic CPT-11 after 6 week evaluation from 0,008% to 0.005% (p = 0.17). Conclusions: Low-dose metronomic C.I. of irinotecan is well tolerated and leads to long-term median PFS in patients with MCRC failed to standard therapy. No significant financial relationships to disclose.
Published Version
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