Phase 2 multi-institutional prospective feasibility study of uracil-tegafur and leucovorin as adjuvant chemotherapy for patients aged 80 years or more after curative resection of colorectal cancer: The HiSCO-03 study.

Authors

null

Masashi Miguchi Sr.

Hiroshima Prefectural Hospital, Hiroshima, Japan;

Masashi Miguchi Sr., Satoshi Ikeda , Manabu Shimomura Sr., Masahiro Nakahara , Tomohiro Adachi , Yasuyo Ishizaki , Yasufumi Saitoh , Kazuhiro Toyota , Daisuke Sumitani , Yosuke Shimizu , Yuji Takakura , Wataru Shimizu , Masanori Yoshimitsu , Shinya Kodama , Masahiko Fujimori , Mamoru Oeda , Hironori Kobayashi , Hideki Ohdan

Organizations

Hiroshima Prefectural Hospital, Hiroshima, Japan; , Hiroshima University, Hiroshima-Shi Minami-Ku, Japan; , Department of Surgery, Onomichi General Hospital, Onomichi, Japan; , Hiroshima City North Medical Center Asa Citizens Hospital, Hiroshima, Japan; , Department of Surgery, Hiroshima-Nishi Medical Center, Ohtake, Japan; , Department of Surgery, Chugoku Rosai Hospital, Kure, Japan; , Department of Surgery, Higashihiroshima Medical Center, Higashihiroshima, Japan; , Department of Surgery, JR Hiroshima Hospital, Hiroshima, Japan; , Kure Medical Center and Chugoku Cancer Center, Kure, Japan; , Department of Surgery, Chuden Hospital, Hiroshima, Japan; , Department of Gastroenterological and Transplant Surgery, Hiroshima University, Hiroshima, Japan; , Hiroshima City Hospital, Hiroshima, Japan; , Yoshida General Hospital, Akitakata, Japan; , Departmetnof surgery, Kure City Medical Association Hospital, Kure, Japan; , Sera Central Hospital, Sera, Japan; , Department of Surgery, Hiroshima Memorial Hospital, Hiroshima, Japan;

Research Funding

No funding received
None.

Background: There is no consensus on the safety and effectiveness of adjuvant chemotherapy for patients with stage III colorectal cancer (CRC) aged ≥80 years who underwent curative resection. We conducted a prospective phase II feasibility study of uracil-tegafur and leucovorin (UFT/LV) as adjuvant chemotherapy in this population. Methods: This study involved 15 institutions of the Hiroshima Surgical Oncology Study Group (HiSCO). Patients with stage III CRC aged ≥80 years who underwent curative resection with an Eastern Cooperative Oncology Group performance status of 0–1 were enrolled. Eligible patients received UFT/LV therapy (UFT, 300 mg/m2 per day as tegafur; LV, 75 mg/day on days 1–28, every 35 days for five courses). Primary endpoint was feasibility, and secondary endpoints were safety and relative dose intensity. Results: Sixty-nine patients were enrolled in the study between December 2013 and June 2021. Of the 69 patients, 65 were included in the analysis, excluding two ineligible patients and two who discontinued before treatment commenced. There were 32 males and 33 females with a median age of 82 years (range, 80–88 years). There were four patients with stage IIIA CRC, 49 with stage IIIB, and 12 with stage IIIC. In the primary endpoint, administration completion rate was 67.3% (95% confidence interval: 54.9The median relative dose intensities were 84% (range, 4–100%) for UFT, and 100% (range, 4–100%) for LV. Incidence of grade three or higher adverse events were neutropenia (1.5%), aspartate transaminase elevation (3%), alanine transaminase elevation (1.5%), oral mucositis (3%), anemia (1.5%), and diarrhea (4.6%). No treatment-related deaths occurred. An independent risk factor was not identified in the background risk factor analysis for treatment discontinuation. Conclusions: Uracil-tegafur and leucovorin are not recommended as standard adjuvant therapy for patients with stage III CRC ≥80 years of age because of the possibility of lower completion rates. The frequency of serious adverse events was acceptable, and safety was confirmed in the treated patients. It is necessary to clarify the background of patients in which administration is discontinued and to investigate the impact on long-term prognosis. Clinical trial information: R000013902.

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Abstract Details

Meeting

2023 ASCO Gastrointestinal Cancers Symposium

Session Type

Poster Session

Session Title

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

Track

Colorectal Cancer,Anal Cancer

Sub Track

Therapeutics

Clinical Trial Registration Number

R000013902

Citation

J Clin Oncol 41, 2023 (suppl 4; abstr 101)

DOI

10.1200/JCO.2023.41.4_suppl.101

Abstract #

101

Poster Bd #

E18

Abstract Disclosures

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