Efficacy and toxicity of fluorouracil, leucovorin plus oxaliplatin (FOLFOX4 and modified FOLFOX6) followed by fluorouracil, leucovorin plus irinotecan(FOLFIRI)for advanced or metastatic colorectal cancer--case studies.

OBJECTIVE

In this study, we investigated the efficacy and toxicity of fluorouracil(FU)+Leucovorin(LV)with oxaliplatin (FOLFOX)and irinotecan(FOLFIRI)for patients with advanced or metastatic colorectal cancer.

METHODS

Eleven patients with advanced or metastatic colorectal cancer underwent chemotherapy, such as FOLFOX4, mFOLFOX6, and FOLFIRI. Four and 7 patients underwent FOLFOX4 and mFOLFOX6 as a first-line therapy, respectively. Five patients underwent FOLFIRI as a second-line therapy.

RESULTS

The response rate(RR)for FOLFOX4 and mFOLFOX6 as a firstline therapy was 0%(0 of 4 patients)and 71%(5 of 7 patients), respectively. The RR for FOLFIRI as a second-line therapy was 40%(2 of 5 patients). The survival time of the eight patients experiencing CR, PR or SD in the firstline FOLFOX4/mFOLFOX6 or the second-line FOLFIRI is 7 to 27 months. That of the three patients not showing CR, PR or SD is 4 to 8 months. The former is significantly longer than the latter(p=0.0023). Toxicities were paresthesia, neutropenia, thrombocytopenia and general fatigue in FOLFOX4, paresthesia, neutropenia, thrombocytopenia, diarrhea and anaphylaxis in mFOLFOX6, while those were neutropenia, thrombocytopenia, stomatitis and general fatigue in the second-line FOLFIRI.

CONCLUSIONS

For advanced or metastatic colorectal cancer, FOLFOX4/mFOLFOX6 followed by FOLFIRI may be effective and comparatively safe treatments.