FOLFOXIRI for First-Line Treatment of Unresectable Colorectal Cancer with Liver Metastases in a Resource-Limited Setting.
Humans
Male
Colorectal Neoplasms
/ pathology
Female
Middle Aged
Liver Neoplasms
/ secondary
Antineoplastic Combined Chemotherapy Protocols
/ therapeutic use
Fluorouracil
/ therapeutic use
Leucovorin
/ therapeutic use
Prospective Studies
Aged
Organoplatinum Compounds
/ therapeutic use
Adult
Camptothecin
/ analogs & derivatives
Vietnam
/ epidemiology
Survival Rate
Resource-Limited Settings
Colorectal cancer
Liver metastasis
Neoadjuvant chemotherapy
Response
Survival
Journal
Journal of gastrointestinal cancer
ISSN: 1941-6636
Titre abrégé: J Gastrointest Cancer
Pays: United States
ID NLM: 101479627
Informations de publication
Date de publication:
31 Oct 2024
31 Oct 2024
Historique:
accepted:
23
10
2024
medline:
1
11
2024
pubmed:
1
11
2024
entrez:
31
10
2024
Statut:
epublish
Résumé
FOLFOXIRI is a standard treatment for unresectable colorectal cancer (CRC) liver metastases. However, limited data exists on its safety and effectiveness in low-to-middle-income countries (LMICs). This prospective study addresses this gap in a Vietnamese LMIC setting. We enrolled 92 patients with unresectable CRC liver metastases between 2022 and 2023. All patients received FOLFOXIRI every 2 weeks, with routine G-CSF prophylaxis to prevent neutropenia. A multidisciplinary team (MDT) assessed diagnoses and treatment responses. Outcomes were R0/R1 resection rate, progression-free survival (PFS), overall survival (OS), objective response rate (ORR), disease control rate (DCR), adverse events (AEs), and recurrence-free survival (RFS) for surgical patients. The median patient age was 56 years, with a male predominance (70.7%). The primary tumors were located in the left colon (42.4%), rectum (37%), and right colon (20.7%). Thirty-two patients (34.8%) experienced severe (grade 3 or higher) AEs, with thrombocytopenia (13.1%) and anemia (9.8%) being the most frequent. Most patients (72/87, 82.9%) achieved a partial response. The ORR and DCR were 85.1% and 95.4%, respectively. Fifty-seven patients (62%) achieved resectability, and 54 (58.7%) underwent radical surgery. The R0/R1 resection rate was 88.9%. The median PFS and OS for all patients were 13 and 22 months, respectively. The median RFS of surgical patients was 14 months. FOLFOXIRI improves the response rates, R0/R1 resection rates, and survivals for patients with CRC liver metastases. Future research is necessary to improve the prognosis of patients while minimizing toxicities. NCT05362825 dated 5 May 2022.
Identifiants
pubmed: 39480530
doi: 10.1007/s12029-024-01133-4
pii: 10.1007/s12029-024-01133-4
doi:
Substances chimiques
Fluorouracil
U3P01618RT
Leucovorin
Q573I9DVLP
Organoplatinum Compounds
0
Camptothecin
XT3Z54Z28A
Banques de données
ClinicalTrials.gov
['NCT05362825']
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
12Informations de copyright
© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
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