Final analysis of colorectal cancer patients treated with irinotecan and 5-fluorouracil plus folinic acid neoadjuvant chemotherapy for unresectable liver metastases

• Published in: British journal of cancer Vol. 97; no. 8; pp. 1035 - 1039
• Main Authors: BARONE, C, NUZZO, G, CASSANO, A, BASSO, M, SCHINZARI, G, GIULIANTE, F, D'ARGENTO, E, TRIGILA, N, ASTONE, A, POZZO, C
• Format: Journal Article
• Language: English
• Published: Basingstoke Nature Publishing Group 22.10.2007
• Subjects: Adenocarcinoma - drug therapy; Adenocarcinoma - mortality; Adenocarcinoma - secondary; Adult; Aged; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological and medical sciences; Camptothecin - administration & dosage; Camptothecin - analogs & derivatives; Clinical Study; Colorectal Neoplasms - drug therapy; Colorectal Neoplasms - metabolism; Colorectal Neoplasms - pathology; Female; Fluorouracil - administration & dosage; Follow-Up Studies; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Irinotecan; Leucovorin - administration & dosage; Liver Neoplasms - drug therapy; Liver Neoplasms - secondary; Liver Neoplasms - surgery; Male; Medical sciences; Middle Aged; Neoadjuvant Therapy; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Survival Analysis; Treatment Outcome; Tumors; Antineoplastic agent; neoadjuvant; Rectal disease; Colorectal cancer; Hepatic disease; Calcium folinate; Neoadjuvant treatment; FOLFIRI; Isomerases; Cancerology; Intestinal disease; liver metastases; Fluorouracil; Human; Folinic acid; Enzyme; colorectal cancer irinotecan; Fluoropyrimidine derivatives; Transferases; DNA topoisomerase; Enzyme inhibitor; Malignant tumor; Thymidylate synthase; Colonic disease; Irinotecan; Chemotherapy; Treatment; Antimetabolic; Methyltransferases; Unresectable; Pyrimidine derivatives; Digestive diseases; Liver metastasis; Cancer
• ISSN: 0007-0920; 1532-1827
• DOI: 10.1038/sj.bjc.6603988

We have previously reported that neoadjuvant therapy with modified FOLFIRI enabled nearly a third of patients with metastatic colorectal cancer (mCRC) to undergo surgical resection of liver metastases. Here, we present data from the long-term follow-up of these patients. Forty patients received modified FOLFIRI: irinotecan 180 mg m(-2), day 1; folinic acid, 200 mg m(-2); and 5-fluorouracil: as a 400 mg m(-2) bolus, days 1 and 2, and a 48-h continuous infusion 1200 mg m(-2), from day 1. Treatment was repeated every 2 weeks, with response assessed every six cycles. Resected patients received six further cycles of chemotherapy postoperatively. Nineteen (47.5%) of 40 patients achieved an objective response; 13 (33%) underwent resection. After a median follow-up of 56 months, median survival for all patients was 31.5 months: for non-resected patients, median survival was 24 months and was not reached for resected patients. Median time to progression was 14.3 and 5.2 months for all and non-resected patients, respectively. Median disease-free (DF) survival in resected patients was 52.5 months. At 2 years, all patients were alive (8 DF), and at last follow-up, eight were alive (6 DF). Surgical resection of liver metastases after neoadjuvant treatment with modified FOLFIRI in CRC patients achieved favourable survival times.