Erschienen in:
01.01.2012 | Original Article
Combining capecitabine, oxaliplatin, and gemcitabine (XELOXGEM) for colorectal carcinoma patients pretreated with irinotecan: a multicenter phase I/II trial
verfasst von:
Se Hyun Kim, Sang Joon Shin, Sun Young Kim, Se Hoon Lee, Young Suk Park, Se Hoon Park, Kyung Hee Lee, Tae Won Kim, Yong Sang Hong, Joong Bae Ahn
Erschienen in:
Cancer Chemotherapy and Pharmacology
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Ausgabe 1/2012
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Abstract
Purpose
Capecitabine plus oxaliplatin (XELOX) is an effective second-line regimen for advanced colorectal carcinoma (CRC) patients pretreated with irinotecan. Previous studies have shown supra-additive anti-tumor activity of gemcitabine (GEM) when administered with oxaliplatin. We investigated the dose, toxicity, and efficacy of a second-line XELOXGEM regimen in CRC patients pretreated with irinotecan.
Methods
Patients with metastatic or recurrent CRC who failed after a first-line irinotecan-containing regimen received escalating doses of gemcitabine (600, 800, 1,000 mg/m2 d1, d8) followed by capecitabine (1,000 mg/m2 b.i.d d1–14) and oxaliplatin (100 mg/m2 d1) on a 21-day cycle.
Results
A total of 38 patients were treated. At 800 mg/m2, two of six patients experienced dose-limiting toxicities (diarrhea and thrombocytopenia). Therefore, the clinically recommended dose was defined as 600 mg/m2 gemcitabine (d1, d8) followed by 1,000 mg/m2 capecitabine (b.i.d dl–14) and 100 mg/m2 oxaliplatin (d1). The most common grade 3/4 toxicities were neutropenia (32%), thrombocytopenia (13%), anemia (11%), and peripheral neuropathy (11%). Ten (26.3%) and 23 (60.5%) patients experienced partial response and stable disease, respectively. The median progression-free survival and overall survival were 5.4 months (95% CI 3.8–6.9 months) and 17.7 months (95% CI 8.4–26.9 months), respectively.
Conclusions
The XELOXGEM triplet combination is an active and safe second-line regimen for advanced CRC patients pretreated with irinotecan.