Multidisciplinary palliation for unresectable recurrent rectal cancer: hypoxic pelvic perfusion with mitomycin C and oxaliplatin in patients progressing after systemic chemotherapy and radiotherapy, a retrospective cohort study.
hypoxic pelvic perfusion with mitomycin C and oxaliplatin
retrospective cohort study
unresectable recurrent rectal cancer
Journal
Oncotarget
ISSN: 1949-2553
Titre abrégé: Oncotarget
Pays: United States
ID NLM: 101532965
Informations de publication
Date de publication:
11 Jun 2019
11 Jun 2019
Historique:
received:
04
04
2019
accepted:
05
05
2019
entrez:
25
6
2019
pubmed:
25
6
2019
medline:
25
6
2019
Statut:
epublish
Résumé
Innovative systemic treatments and loco-regional chemotherapy by hypoxic pelvic perfusion (HPP) have been proposed for unresectable recurrent rectal cancer (URRC). Regorafenib and trifluridine-tipiracil reported significantly increased PFS 1.9-2.0 months, OS 6.4-7.1 months vs placebo, respectively. Present study evaluated safety and efficacy of mitomycin/oxaliplatin HPP associated to intravenous cetuximab, and of third line systemic therapy in clinical practice. HPP consisted of: isolation, perfusion, chemofiltration. Patients received mitomycin 25 mg/m From 2005 to 2018, 49 URRC patients were enrolled; 33 in HPP/target-therapy, 16 in systemic therapy control group. No HPP related complications were reported. Most common adverse events were skin, bone marrow toxicities. In HPP/target-therapy group, ORR and DCR were 36.4 and 100%; in systemic therapy control group, 18.7 and 31.25%, respectively. In HPP/target-therapy compared with systemic therapy group, respectively, DCR seemed significantly favourable ( Present data showed that integration of HPP/target-therapy may be effective in local control, and efficacy as third line treatment of URCC patients. This therapeutic strategy deserves further prospective randomized trials to be compared to conventional systemic treatments.
Sections du résumé
BACKGROUND
BACKGROUND
Innovative systemic treatments and loco-regional chemotherapy by hypoxic pelvic perfusion (HPP) have been proposed for unresectable recurrent rectal cancer (URRC). Regorafenib and trifluridine-tipiracil reported significantly increased PFS 1.9-2.0 months, OS 6.4-7.1 months vs placebo, respectively. Present study evaluated safety and efficacy of mitomycin/oxaliplatin HPP associated to intravenous cetuximab, and of third line systemic therapy in clinical practice.
METHODS
METHODS
HPP consisted of: isolation, perfusion, chemofiltration. Patients received mitomycin 25 mg/m
RESULTS
RESULTS
From 2005 to 2018, 49 URRC patients were enrolled; 33 in HPP/target-therapy, 16 in systemic therapy control group. No HPP related complications were reported. Most common adverse events were skin, bone marrow toxicities. In HPP/target-therapy group, ORR and DCR were 36.4 and 100%; in systemic therapy control group, 18.7 and 31.25%, respectively. In HPP/target-therapy compared with systemic therapy group, respectively, DCR seemed significantly favourable (
CONCLUSIONS
CONCLUSIONS
Present data showed that integration of HPP/target-therapy may be effective in local control, and efficacy as third line treatment of URCC patients. This therapeutic strategy deserves further prospective randomized trials to be compared to conventional systemic treatments.
Identifiants
pubmed: 31231460
doi: 10.18632/oncotarget.26972
pii: 26972
pmc: PMC6570475
doi:
Types de publication
Journal Article
Langues
eng
Pagination
1-13Déclaration de conflit d'intérêts
CONFLICTS OF INTEREST The Authors declare that there is no conflicts of interest.
Références
Arch Surg. 2001 Jan;136(1):105-12
pubmed: 11146790
Br J Surg. 2001 Jul;88(7):988-93
pubmed: 11442533
Anticancer Res. 2004 May-Jun;24(3b):2093-6
pubmed: 15274406
J Chemother. 2004 Nov;16 Suppl 5:51-4
pubmed: 15675479
J Palliat Care. 1991 Summer;7(2):6-9
pubmed: 1714502
Eur J Surg Oncol. 2007 Feb;33(1):72-8
pubmed: 17166688
Tumori. 2006 Sep-Oct;92(5):402-6
pubmed: 17168432
Pancreas. 2008 Jan;36(1):56-60
pubmed: 18192882
Surg Oncol Clin N Am. 2008 Oct;17(4):825-42, ix-x
pubmed: 18722921
Eur J Cancer. 2009 Jan;45(2):228-47
pubmed: 19097774
BMC Cancer. 2010 Oct 19;10:567
pubmed: 20958992
Exp Mol Pathol. 2012 Jun;92(3):296-303
pubmed: 22440733
Lancet. 2013 Jan 26;381(9863):303-12
pubmed: 23177514
Acta Radiol. 2014 Sep;55(7):793-801
pubmed: 24097815
Int J Oncol. 2014 Jan;44(1):17-26
pubmed: 24247407
Biomed Res Int. 2013;2013:143273
pubmed: 24307987
Int J Oncol. 2014 Jun;44(6):1820-30
pubmed: 24715238
N Engl J Med. 2015 May 14;372(20):1909-19
pubmed: 25970050
Lancet Oncol. 2015 Jun;16(6):619-29
pubmed: 25981818
Ann Surg Oncol. 2016 Oct;23(11):3609-3615
pubmed: 27169769
Oncotarget. 2017 Jun 6;8(23):37875-37883
pubmed: 28053287
Arch Pathol Lab Med. 2017 May;141(5):625-657
pubmed: 28165284
World J Gastroenterol. 2017 Jun 21;23(23):4170-4180
pubmed: 28694657
Updates Surg. 2017 Sep;69(3):403-410
pubmed: 28791628
BMC Res Notes. 2017 Aug 15;10(1):411
pubmed: 28810925
Oncotarget. 2018 Apr 3;9(25):17906-17914
pubmed: 29707156
Updates Surg. 2018 Dec;70(4):441-447
pubmed: 30191532
Ther Adv Med Oncol. 2019 May 10;11:1758835919846421
pubmed: 31205502
Int J Radiat Oncol Biol Phys. 1997 Jul 1;38(4):785-90
pubmed: 9240647
J Clin Pharmacol. 1998 Oct;38(10):936-44
pubmed: 9807975