Comparing time to disease progression of irinotecan and oxaliplatin-based chemotherapies in colorectal cancer patients with liver only metastasis

Am J Clin Oncol. 2013 Aug;36(4):388-91. doi: 10.1097/COC.0b013e318248da7c.

Abstract

Objectives: The liver is the most common metastatic site in colorectal cancer (CRC). In this study, we evaluated if there is any difference between first-line irinotecan-based and oxaliplatin-based chemotherapies in the duration of time to disease progression (TTP) in CRC patients with only liver metastasis.

Methods: We retrospectively reviewed the medical records of patients with metastatic CRC referred to the Medical Oncology Department at the Faculty of Medicine of Ege University, between January 2002 and December 2010. Seventy-seven patients had only liver metastasis and completed their first-line chemotherapy. Forty-two patients had oxaliplatin-based treatments while 12 also had bevacizumab therapy, and 35 patients had irinotecan-based treatments while 16 also had bevacizumab therapy.

Results: Median TTP was 6.70 ± 0.29 months for patients treated with oxaliplatin+5-fluorouracil (5-FU) and 8.33 ± 1.15 months for patients treated with oxaliplatin+5-FU+bevacizumab. TTP was significantly improved for patients who received irinotecan+5-FU+bevacizumab (median TTP, 13.73 ± 2.10 mo) when compared with irinotecan+5-FU (median TTP, 5.13 ± 0.70 mo).

Conclusions: Although previous studies showed no survival difference between these 2 chemotherapeutic agents in metastatic CRC, there might be differences in the benefit of delaying the disease progression in subgroup populations. Irinotecan+5-FU with bevacizumab combination chemotherapy may be superior in the first-line treatment of CRC with hepatic only metastasis.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols
  • Camptothecin / analogs & derivatives*
  • Camptothecin / therapeutic use
  • Cohort Studies
  • Colorectal Neoplasms / drug therapy*
  • Colorectal Neoplasms / mortality
  • Colorectal Neoplasms / pathology
  • Databases, Factual
  • Disease Progression
  • Disease-Free Survival
  • Female
  • Fluorouracil
  • Follow-Up Studies
  • Humans
  • Infusions, Intravenous
  • Irinotecan
  • Leucovorin
  • Liver Neoplasms / drug therapy
  • Liver Neoplasms / mortality
  • Liver Neoplasms / secondary*
  • Male
  • Middle Aged
  • Neoplasm Invasiveness / pathology
  • Neoplasm Recurrence, Local / mortality
  • Neoplasm Recurrence, Local / pathology*
  • Neoplasm Staging
  • Organoplatinum Compounds / therapeutic use*
  • Oxaliplatin
  • Retrospective Studies
  • Risk Assessment
  • Survival Analysis
  • Time Factors
  • Treatment Outcome

Substances

  • Organoplatinum Compounds
  • Oxaliplatin
  • Irinotecan
  • Leucovorin
  • Fluorouracil
  • Camptothecin

Supplementary concepts

  • Folfox protocol