Phase I/II Trial of Irinotecan and S-1 Combination Chemotherapy as a Second-Line Treatment for Advanced Colorectal Cancer

Abstract

Background: This study attempted to determine the therapeutic dosage of irinotecan and S-1 (IRIS) as a second-line treatment for colorectal cancer (CRC). Methods: S-1 was administered on days 1-14 of a 28-day cycle. Irinotecan was administered on days 1 and 15. The irinotecan dose was then escalated to determine the maximum-tolerated dose and the recommended dose at a fixed dosage of S-1 (80 or 65 mg·m^-2·day^-1). The S-1 dose was reduced to 65 mg·m^-2·day^-1 when dose-limiting toxicities were observed at 80 mg·m^-2· day^-1 and the irinotecan dose was increased. Results: The recommended dose was 65 mg/m² for S-1 and 75 mg/m² for irinotecan. Twenty-one patients were treated at the recommended dose. The overall response rate was 28.6%. Conclusion: This modified IRIS regimen is considered effective with acceptable toxicities for advanced CRC resistant to treatment with 5-fluorouracil/leucovorin or uracil and tegafur/leucovorin.

5-Fluorouracil induces apoptosis of colorectal cancer cells

“…In order to effectively eliminate cancer cells, clinicians need to increase the drug dose. However, this may cause various adverse effects, such as hair loss, nausea, diarrhea, and dermatitis (Takii et al, 2013). To minimize such side effects from 5-FU treatment, it is necessary to increase the sensitivity of cancer cells to 5-FU.…”

Synchronous Triple Primary Cancer of the Esophagus, Stomach and Jejunum: A Case Report and Review of Literature

“…Three months after operation, without anastomotic stenosis, which was confirmed by barium esophagography (Figure 4). Considering his continuous low white blood cell levels, physical and economic conditions, he didn't receive radiotherapy and started to receive SOX adjuvant chemotherapy for six cycles with cisplatin and S-1(an oral fluoropyrimidine produced by combining tegafur, a prodrug of 5-FU, with 5-chloro-2, 4-dihy-droxypyridine and potassium oxonate) [8]. After 12 months of follow-up, the patient is still alive and under regular follow-up.…”

Cetuximab Plus Various Chemotherapy Regimens for Patients with KRAS Wild-Type Metastatic Colorectal Cancer

“…For the last 40 years, the standard treatment for unresectable and/or metastatic colorectal cancer (mCRC) has been fluoropyrimidine-based systemic chemotherapy [3,4]. Oral fluoropyrimidines were shown to be as effective as intravenous ones with a greater safety and convenience for patients [5]. With the introduction of modern chemotherapy agents like irinotecan and oxaliplatin, the median overall survival (OS) of patients has significantly improved [6,7,8,9].…”