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Erschienen in: International Journal of Clinical Oncology 5/2011

01.10.2011 | Original Article

Modified FOLFOX6 with oxaliplatin stop-and-go strategy and oral S-1 maintenance therapy in advanced colorectal cancer: CCOG-0704 study

verfasst von: Goro Nakayama, Yasuhiro Kodera, Hiroyuki Yokoyama, Naoto Okuda, Takuya Watanabe, Chie Tanaka, Naoki Iwata, Norifumi Ohashi, Masahiko Koike, Michitaka Fujiwara, Akimasa Nakao

Erschienen in: International Journal of Clinical Oncology | Ausgabe 5/2011

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Abstract

Background

A combination of fluorouracil and leucovorin (5-FU/LV) with oxaliplatin (FOLFOX) is an established first-line therapy for metastatic colorectal cancer (mCRC). However, the cumulative neurotoxicity of oxaliplatin often requires therapy to be discontinued while the patient is still responding. A strategy to stop FOLFOX, deliver 5-FU/LV as a maintenance therapy and reintroduce FOLFOX was found to be equivalent in terms of efficacy while neurotoxicity was substantially reduced. The aim of this study was to evaluate feasibility of a stop-and-go strategy with S-1, an oral fluoropyrimidine derivative, as a maintenance therapy administered between modified FOLFOX6 (mFOLFOX6) as a first-line treatment of mCRC.

Methods

Thirty patients with untreated mCRC were treated with six cycles of mFOLFOX6 followed by maintenance therapy with oral S-1. Reintroduction of mFOLFOX6 was scheduled after four cycles of S-1 or upon tumor progression. The primary endpoint was duration of disease control (DDC).

Results

Twenty-one of the 30 patients who achieved responses or stabilizations received S-1 maintenance therapy. mFOLFOX6 was reintroduced in 15 patients. Median DDC and progression-free survival were 9.3 and 7.9 months, respectively. The response rates and disease control rates were 40.0 and 86.6% for the initial mFOLFOX6, 23.8 and 57.1% for S-1 maintenance therapy and 20.0 and 73.3% for mFOLFOX6 reintroduction, respectively. Twenty-eight patients (93.3%) had peripheral neuropathy, but grade 3 neurotoxicity was observed in only 1 patient (3.3%).

Conclusion

The planned oxaliplatin stop-and-go strategy with oral S-1 maintenance therapy was feasible as a first-line treatment for Japanese mCRC patients. Further prospective randomized control study is warranted.
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Metadaten
Titel
Modified FOLFOX6 with oxaliplatin stop-and-go strategy and oral S-1 maintenance therapy in advanced colorectal cancer: CCOG-0704 study
verfasst von
Goro Nakayama
Yasuhiro Kodera
Hiroyuki Yokoyama
Naoto Okuda
Takuya Watanabe
Chie Tanaka
Naoki Iwata
Norifumi Ohashi
Masahiko Koike
Michitaka Fujiwara
Akimasa Nakao
Publikationsdatum
01.10.2011
Verlag
Springer Japan
Erschienen in
International Journal of Clinical Oncology / Ausgabe 5/2011
Print ISSN: 1341-9625
Elektronische ISSN: 1437-7772
DOI
https://doi.org/10.1007/s10147-011-0214-6

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