Triplet therapy with oxaliplatin, irinotecan, 5-fluorouracil and folinic acid within a combined modality approach in patients with liver metastases from colorectal cancer

Cámara, J. De La; Rodriguez, J.; Rotellar, Fernando; Viúdez, A.; Garcı́a-Foncillas, Jesús; Pardo, Fernando; Gil‐Bazo, Ignacio; Chopitea, Á.; Martín‐Algarra, Salvador

doi:10.1200/jco.2004.22.90140.3593

Cited by 23 publications

(12 citation statements)

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“…The high level of activity attained has allowed us to perform hepatic resection in 40% of the patients with previously non-resectable liver metastases, superior to the 26Á36% rate reported by Falcone et al [17,20], the 29% reported by Gil-Delgado et al [13], and the 37.5% communicated by Quenet [34] all using a triple combination plus LV. Our results are similar to the 40.9% complete resection rate communicated by De La Camara in previously unresectable liver metastasis using FOLFORINOX regimen [35,36]. Recently the NCCTG has reported a prospective clinical trial in patients with non-resectable liver metastasis [37].…”

Section: Discussionsupporting

confidence: 89%

Colorectal cancer metastasis resectability after treatment with the combination of oxaliplatin, irinotecan and 5-fluorouracil. Final results of a phase II study

et al. 2008

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Section: Discussionsupporting

confidence: 89%

Colorectal cancer metastasis resectability after treatment with the combination of oxaliplatin, irinotecan and 5-fluorouracil. Final results of a phase II study

et al. 2008

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“…In a preliminary study in 39 patients with unresectable liver metastases, the response rate was 64% and secondary surgery was possible in 23 patients (59%) [32] . Of these patients, 84% achieved R0 resection.…”

Section: -Yr Dfs < 5%mentioning

confidence: 98%

“…combination of 5-fluorouracil, oxaliplatin, and irinotecan (FOLFOXIRI) [16,31,32] , with the rationale of maximizing concurrent exposure to multiple active agents [14,33] . In a preliminary study in 39 patients with unresectable liver metastases, the response rate was 64% and secondary surgery was possible in 23 patients (59%) [32] .…”

Section: -Yr Dfs < 5%mentioning

confidence: 99%

Secondary hepatic resection as a therapeutic goal in advanced colorectal cancer

Saif¹

2009

WJG

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Surgery is the only curative option for patients with liver metastases of colorectal cancer, but few patients present with resectable hepatic lesions. Chemotherapy is increasingly used to downstage initially unresectable disease and allow for potentially curative surgery. Standard chemotherapy regimens convert 10%-20% of cases to resectable disease in unselected populations and 30%-40% of those with disease confined to the liver. One strategy to further increase the number of candidates eligible for surgery is the addition of active targeted agents such as cetuximab and bevacizumab to standard chemotherapy. Data from a phase Ⅲ trial indicate that cetuximab increases the number of patients eligible for secondary hepatic resection, as well as the rate of complete resection when combined with first-line treatment with the FOLFIRI regimen. The safety profiles of preoperative cetuximab or bevacizumab have not been thoroughly assessed, but preliminary evidence indicates that these agents do not increase surgical mortality or exacerbate chemotherapyrelated hepatotoxicity, such as steatosis (5-fluorouracil), steatohepatitis (irinotecan), and sinusoidal obstruction (oxaliplatin). Secondary resection is a valid treatment goal for certain patients with initially unresectable liver metastases and an important end point for future clinical trials. INTRODUCTIONGlobally, one half of the nearly 1 million patients diagnosed with colorectal cancer annually will develop liver metastases during the course of the disease [1,2] . Autopsy findings suggest that approximately 50% of patients who die of colorectal cancer have liver metastases, which are the only site of metastatic disease in approximately 20%-30% of patients [3] and the cause of death in most of these patients [4] . In other types of cancer, liver metastases are a sign of distant dissemination, and surgery is not a curative option [5] . In colorectal cancer, however, portal vein drainage from the gastrointestinal tract to the liver favors metastasis to the liver without systemic dissemination [5] . Surgery therefore provides a potentially curative treatment option for patients with resectable liver disease [6] , in contrast with palliative chemotherapy for those with unresectable disease.One of the most important recent advances in the management of advanced colorectal cancer is the concept of downstaging initially unresectable disease using chemotherapy so that more patients become eligible for potentially curative surgery. Current treatment guidelines [4] and substantial research highlight the importance of increasing the rates of secondary resection in initially unresectable disease. The addition of active targeted therapies, such as cetuximab and bevacizumab, to chemotherapy may further increase secondary resection rates. This article summarizes the current data on secondary resection of initially unresectable liver metastases of colorectal cancer using currently available systemic therapy regimens. HOW RESECTABILITY MAY BE ACHIEVEDReported 5-year survival r...

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“…1) particularly when patients were preselected for their irresectability at entry into datasets. This assessment could be criticized as it was based on a very selected group of studies [102][103][104][107][108][109][110] where resection was considered as the primary endpoint only in three cases [102,104,110]. The correlation between tumour response and resection in nonselected patients was based on data from a much larger number of studies assessing over 2900 patients where the relation between RR and RER although less strong was still highly significant (p < 0.001).…”

Section: Neoadjuvant Chemotherapy: Current Controversiesmentioning

confidence: 98%

The management of colorectal liver metastases: Expanding the role of hepatic resection in the age of multimodal therapy

Chiappa

Makuuchi

Lygidakis

et al. 2009

Critical Reviews in Oncology/Hematology

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Triplet therapy with oxaliplatin, irinotecan, 5-fluorouracil and folinic acid within a combined modality approach in patients with liver metastases from colorectal cancer

Cited by 23 publications

References 0 publications

Colorectal cancer metastasis resectability after treatment with the combination of oxaliplatin, irinotecan and 5-fluorouracil. Final results of a phase II study

Colorectal cancer metastasis resectability after treatment with the combination of oxaliplatin, irinotecan and 5-fluorouracil. Final results of a phase II study

Secondary hepatic resection as a therapeutic goal in advanced colorectal cancer

The management of colorectal liver metastases: Expanding the role of hepatic resection in the age of multimodal therapy

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