Ftorafur, an active tumor drug, is less toxic than 5‐fluorouracil and was most effective in cancer of the breast and cancer of the large bowel.

e15583 Background: The first and second lines of CT is decisive in the treatment of colorectal cancer. Choosing the right one allows you to increase PFS and improve long-term results. Surgical treatment and maintenance chemotherapy (MT) increase PFS and OS, as they can be prescribed at any stage of treatment. Methods: The analysis included 192 patients diagnosed with metastatic colorectal cancer (mCRC) who received treatment between 2014 and 2019. The average age of the patients was 62 years. At the beginning of treatment, the overall condition of all patients was ECOG1. Primary mCRC had 129 (67%) patients. In 63 (33%) patients, locally advanced disease was first diagnosed, which were included in the study after progression. PFS and OS for all patients were calculated from the start of the 1st line. Localization of the primary tumor in 42 (22%) patients was on the right side of the colon and on the left side in 149 (78%) and 1 patient did not show primary tumor. Among the patients with primary metastatic disease, 100 (52%) had isolated metastases, while the remaining 92 (48%) had 2 or more localizations. Different types of surgical treatment of metastases in the liver occurred in 41 (21%) patients. 119 patients never received MT (with any number of lines) and made a comparison group(A). 73 patients received MT in at least one of the CT lines (B). 12 patients received MT in the 1st and 2nd CT (C). These groups were homogeneous in terms of gender, age, ECOG, accessibility of surgical treatment of distant metastasis, mutational status of the tumor, and accessibility of biotherapy. Evaluation of the effect was performed using RECIST criteria, at intervals of 3 months or the appearance of clinical symptoms of progression. The treatment was carried out before the progression. At the time of analysis, 94 patients are alive and continue to receive treatment. Results: We compared in all three groups: In group A: OS - 12.9 months, PFS 1-line CT - 9.5 months, PFS 2-line CT - 4.5 months In group B: OS - 27.6 months, PFS 1-line CT - 13.6 months, PFS 2-line CT - 9.1 months In group C: OS - 38.3 months, PFS 1-line CT - 14.2 months, PFS 2-line CT - 9.1 months. “Five-year” survival (In those patients who were observed from the start of the study for all 5 years) in group A was 5,8 %, in group B 15 %, and in group C 16 %. Conclusions: Increase of PFS and OS in patients who received MT at least at one of the stages of treatment, and continues to increase in patients receiving MT in the first two lines CT. Thus, MT is a necessary component of the treatment of mCRC.

Objective. Gastric cancer is the fifth most common malignancy and the third leading cause of the cancer mortality worldwide. It is most often diagnosed at a locally advanced or metastatic stage. Angiogenesis has become an important target in the treatment of solid tumors, and antiangiogenic agents are a promising approach to cancer therapy. In this review, we summarize the current literature on the treatment of gastric and gastroesophageal cancer with ramucirumab, an antiangiogenic agent specifically targeting vascular endothelial growth factor receptor-2 (VEGFR-2). Material and methods. We conducted a systematic search in May 2016 of PubMed and relevant congress proceedings including the American Society of Clinical Oncology, the European Society for Medical Oncology, and the European Cancer Congress. Included studies were aimed to prospectively evaluate the efficacy and safety of ramucirumab in advanced gastric or gastroesophageal cancer. Results. Our search yielded 91 publications including 5 manuscripts and 6 congress abstracts meeting the predefined inclusion criteria. Included studies reported outcomes were related to ramucirumab in gastric cancer, published within the past 5 years. Conclusion. Second-line treatment with ramucirumab, either as monotherapy or in combination with paclitaxel, significantly improves the survival of patients with advanced gastric cancer. Ramucirumab is well tolerated and has an acceptable safety profile. Furthermore, the patient quality of life is maintained with delayed both symptom worsening and deterioration of the functional status. Studies are required to identify potential predictive biomarkers of ramucirumab efficacy.

Introduction: mFOLFOX6þantiEGFR antibody is a standard-of-care in the 1st line chemotherapy of metastatic colorectal cancer. Two molecular targeted drugs, i.e. cetuximab (Cet) and panitumumab (Pani), are the choices of antiEGFR antibody, but the proper use of these drugs are not clarified yet. Cet, IgG subclass1 antibody, is demonstrated to have ADCC activity and other immune, inflammatory functions. Differences of the activities of these two antibodies could be analyzed from this standpoint using the kinetic evaluations of neutrophil-to-lymphocyte ratio (NLR), which is the indicator of cancer-related immune and inflammatory activities. Methods: 50 pts with RAS wild metastatic colorectal cancer were enrolled and treated with mFOLFOX6þantiEGFR antibody (25 pts with Cet, 25 pts with Pani). NLR was measured at the points of pre-treatment (preT), early-tumor-shrinkage (ETS) and gression of disease (PD). The associations of NLR and clinical outcomes were evalua ing by Spearman's rank correlation coefficient, and two-sample Mann-Whitney U were performed with several variants between Cet and Pani pts. Results: The median follow-up time for censored cases was 28 months (m) (IQR, 14-52). Progression free survival (PFS) and overall survival (OS) were 10.9m (95% C.I;7.9-12.6) and 30.0m (95% CI; 20.4-41.2), respectively. PFS and OS of Cet and Pani pts were not different significantly different [PFS: 12.0m (95% CI; 7.2-16.2) vs 9.5m (95% CI; 7.8-12.1), p ¼ 0.23; OS: 30.0m (95% CI; 21-49.9) vs 33.1m (95% CI; 13-41.9), p ¼ 0.202]. NLR at preT and PD were significantly correlated with OS, -0.291(p ¼ 0.0422) and -0.347 (p ¼ 0.0413), respectively. Correlation of PFS with NLR at ETS and with the difference of NLR between preT and ETS, were -0.415 (p ¼ 0.0391) and -0.355 (p ¼ 0.0816) in Cet pts, whereas there were no significant trends of correlation in Pani pts, 0.272 (p ¼ 0.209) and 0.598 (p ¼ 0.002), respectively. Conclusion: Our results suggest that NLR kinetics could reflect the treatment outcomes and kinetic analysis would lead to the stratification of clinical use of Cet and Pani. Cet, rather than Pani, might have more immune and inflammatory associations in the 1st line chemotherapy of RAS wild metastatic colorectal cancer. Clinical trial information: UMIN000031535.

No abstract