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 23 February 2018

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Improving progression-free survival in colorectal cancer

Irinotecan added to the standard fluorouracil/folinic acid regimen is associated with improved progression-free survival and response rate, is well tolerated, and is a reference first-line treatment, finds August's Journal of Clinical Oncology.

News image

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Dr Claus-Henning Köhne and colleagues examined prolonging progression-free survival.

The investigative team added irinotecan to a standard weekly schedule of high-dose, infusional fluorouracil and leucovorin/folinic acid.

The team randomly assigned 430 patients with measurable or assessable metastatic colorectal cancer.

The patients received either folinic acid 500 mg/m2 as a 2-hour infusion or fluorouracil 2.6 g/m2 by intravenous 24-hour infusion.

Both treatments were administered weekly for 6 weeks, and then patients were divided into 2 groups.

The response rate was 62% in the experimental group vs 34% in the placebo arm
Journal of Clinical Oncology

Patients in Group 1, the placebo arm, had a 2-week rest period after their initial treatments.

Group 2, the experimental group, had a similar initial schedule but then received fluorouracil 2 g/m2 preceded by irinotecan 80 mg/m2 administered over 30 minutes.

The investigators found that the median progression-free survival time in Group 2, the experimental group, was 9 months vs 6 months in Group 1.

The investigative team noted that the median overall survival time increased from 17 to 20 months.

The objective response rate was 62% in Group 2, the experimental group, and 34% in Group 1.

Dr Köhne's team concludes, “Addition of irinotecan to the standard fluorouracil/folinic acid regimen was associated with a highly significant improvement in progression-free survival and response rate and was well tolerated.”

“The results of this study confirm that irinotecan in combination with high-dose infusional fluorouracil/folinic acid is a reference first-line treatment.”

J Clin Onc 2005: 23(22): 4856-65
03 August 2005

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