Dr Pascal Gervaz

Chirurgien FMH, chirurgie interne & chirurgie viscérale

 

 

Oxaliplatin Combined With Irinotecan and 5-Fluorouracil / Leucovorin (OCFL) in Metastatic Colorectal Cancer: A Phase I-II Study

 

 

 

by Seium Y, Stupp R, Ruhstaller T, Gervaz P, Mentha G, Philippe M, Allal A, Trembleau C, Bauer J, Morant R, Roth AD.

 

 

Background

A phase I-II multicenter trial was conducted to define the maximal tolerated dose and describe the activity of an OCFL combination using oxaliplatin (OHP), irinotecan (CPT-11) and 5-fluorouracil (FU)/leucovorin (LV) in metastatic colorectal cancer (CRC).

 

Patients and methods

CRC patients not pretreated with palliative chemotherapy, with performance status < or =1 and adequate haematological, kidney and liver function, were eligible. Treatment consisted in weekly 24-h infusion 5-FU (2300 mg/m(2))/LV (30 mg) and alternating OHP (70-85 mg/m(2), days 1 and 15) and CPT-11 (80-140 mg/m(2), days 8 and 22) repeated every 5 weeks. OHP and CPT-11 were escalated in cohorts of three to six patients.

 

Results

Thirty patients received a median of five cycles. Dose-limiting toxicity occurred at dose level 3, and the recommended dose was OHP 70 mg/m(2), CPT-11 100 mg/m(2), LV 30 mg and 5-FU 2300 mg/m(2)/24 h. Grade > or =3 toxicities were diarrhea 23%, neutropenia 20%, fatigue 7%, and neurologic 7%. Two febrile neutropenia episodes (one fatal) were recorded. Among 28 patients with measurable disease (90%), we observed two complete and 20 partial responses; overall RR was 78% (95% CI, 59% to 92%). Median time to progression and overall survival were 9.5 and 25.4 months, respectively. Seven patients underwent liver metastases resection.

 

Conclusion

OCFL is an overall well tolerated regimen with very high efficacy, which makes it most suitable for tumour control before surgery of metastatic disease.

 

 

in Annals of oncology : official journal of the European Society for Medical Oncology / ESMO, 2005 May;16(5):762-6. Epub 2005 Apr 7