P-329 - Reintroduction of oxaliplatin for patients with metastatic colorectal cancer

Date 04 July 2015
Event WorldGI 2015
Session Posters
Topics Anti-Cancer Agents & Biologic Therapy
Colon Cancer
Rectal Cancer
Presenter M. Ristic
Citation Annals of Oncology (2015) 26 (suppl_4): 1-100. 10.1093/annonc/mdv233
Authors M. Ristic, J. Spasic, N. Stanic, V. Nikolic, D. Ristic, D. Radosavljevic
  • Institute of Oncology and Radiology of Serbia, Belgrade/RS

Abstract

Introduction

Oxaliplatin-based chemotherapy is an effective first- and second-line treatment for patients with metastatic colorectal cancer (mCRC). We aimed to assess the effectiveness and safety of the reintroduction of oxaliplatin, as a salvage therapy in patients who were sequentially treated with oxaliplatin followed by irinotecan, after disease progression on irinotecan.

Methods

This retrospective analysis included patients with CRC who were retreated with chemotherapy FOLFOX4. All patients had initial metastatic disease, and were treated earlier with FOLFOX4 as the first line therapy. Minimum PFS in first line FOFLOX4 was at least 6 months. Patients were retreated with oxaliplatin based chemotherapy until best response is achieved (maximum 12 cycles of chemotherapy), progression of disease or limiting toxicity.

Results

Between January 2010 and February 2015 43 patients with CRC were retreated with FOLFOX4 chemotherapy, 25 male (58%) and 18 female (42%), with good performance status (PS 0 and 1). The median age was 60 years at diagnosis, range 29 to 77. 20 patients had colon as primary origin of tumor, and 23 had rectal carcinoma. The median number of cycles of retreatment was 8.

Best response to therapy was: SD (26 patients, 60%), while 8 patients had PR (19%), and 9 patients (21%) had progression of disease on first control. Progression of disease was confirmed in 41 patients, and only 2 still receive FOLFOX4 retreatment.

Median progression-free survival (PFS) was 7 months (5.23-8.76 for CI 95%). Mean progression-free survival (PFS) was 6.97 months (5.88-8.07 for CI 95%). Median PFS for primary rectal carcinoma was 8 months, and for colon cancer was 5 months, but comparison of means didn't confirmed statistically significant difference between these groups (te 1.75; p = 0.087).

The some form of registered hematological toxicity had 24 patients, with usual development after 3 cycles (median).

Conclusion

Reintroduction of oxaliplatin can be considered as safe and efficient option in the salvage treatment of metastatic colorectal cancer patients with good PS and response on initial treatment. Our results should be confirmed by further large prospective studies.