Triplet chemotherapy (TC) with FOLFIRINOX regimen in metastatic colorectal cancer (mCRC): Experience of two French centres.

Authors

null

Emmanuelle Samalin

Institut régional du Cancer de Montpellier, Val d'Aurelle, Montpellier, France

Emmanuelle Samalin , Christelle De La Fouchardiere , Simon Thézenas , Matthieu Sarabi , Eric Assenat , Fabienne Portales , Sebastien Carrere , Michel Rivoire , Philippe Rouanet , Jean-Pierre Bleuse , François Quenet , Marc Ychou

Organizations

Institut régional du Cancer de Montpellier, Val d'Aurelle, Montpellier, France, Centre Léon Bérard, Lyon, France, Montpellier Cancer Institute, Montpellier, France, Institut du Cancer de Montpellier Val d'Aurelle, Montpellier, France, Val d'Aurelle Cancer Institute, Montpellier, France, ICM, Montpellier, France, Surgery Department, Institut du Cancer de Montpellier, Montpellier, France, Oncology Department, Institut du Cancer de Montpellier, Montpellier, France

Research Funding

No funding sources reported

Background: TC is a treatment option for mCRC to improve the tumour response rate in selected patients (pts) and the conversion rate of initially nonresectable liver metastases. The aim of this study was to evaluate the impact and feasibility of FOLFIRINOX regimen in mCRC pts. Methods: We selected all mCRC pts from the ICM and CLB French centres with unresectable disease treated from October 2000 to May 2012 with FOLFIRINOX alone or combined with bevacizumab or cetuximab. Clinical data were collected in a mCRC-specific data base and analysed. Results: 159 pts (52% of men), median age 58 yrs (range: 24-76) were treated with FOLFIRINOX (D1 oxaliplatin 85 mg/m² IV over 2H, then irinotecan 180 mg/m² IV over 90 min and elvorin 200 mg/m², then 5-fluorouracile 200 mg/m² and 2,400 mg/m² IV over 46H, D1=D15) alone (68%) or combined with cetuximab (24%) or bevacizumab (8%) as first–line treatment (88%). Primary tumour was located in colon (77%) or rectum (23%), and 134 pts (84%) presented with synchronous metastases: liver (96%), lung (46%), peritoneum (11%) and nodes (20%). Median number of courses was 8 (range: 1-26). There was 1 toxic death. Grade 3-4 toxicities were as follows: diarrhoea (23%), neuropathy (24%), cutaneous (9%), neutropenia (21%), febrile neutropenia (1%), thrombopenia (4%). Objective response rate according to RECIST V1.0 was 72% [95% CI: 65-79] including 12 pts with complete response. The primary tumour was resected in 127 pts (79%) and 19% had KRAS mutated tumour. Among the 105 pts (66%) with initially non-resectable liver-limited disease (LLD), 59 pts (56%) were eligible for secondary resection and a R0 resection rate was achieved for 44 pts. Median overall survival was 49 months [95% CI: 37-62] and 72 months [95% CI: 48-84] in resected LLD population. Conclusions: These results confirm the feasibility of FOLFIRINOX regimen with or without targeted therapies and its efficacy in LLD selected mCRC population.

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Abstract Details

Meeting

2015 Gastrointestinal Cancers Symposium

Session Type

Poster Session

Session Title

General Poster Session C: Cancers of the Colon, Rectum, and Anus

Track

Cancers of the Colon, Rectum, and Anus

Sub Track

Multidisciplinary Treatment

Citation

J Clin Oncol 33, 2015 (suppl 3; abstr 776)

DOI

10.1200/jco.2015.33.3_suppl.776

Abstract #

776

Poster Bd #

F14

Abstract Disclosures