Sequential administration of XELOX and XELIRI is effective, feasible and well tolerated by patients with metastatic colorectal cancer

Fukui,Taro; Suzuki,Koichi; Ichida,Kosuke; Takayama,Yuji; Kakizawa,Nao; Muto,Yuta; Hasegawa,Fumi; Watanabe,Fumiaki; Kikugawa,Rina; Saito,Masaaki; Tsujinaka,Shingo; Miyakura,Yasuyuki; Rikiyama,Toshiki

doi:10.3892/ol.2017.6100

Sequential administration of XELOX and XELIRI is effective, feasible and well tolerated by patients with metastatic colorectal cancer

Authors:
- Taro Fukui
- Koichi Suzuki
- Kosuke Ichida
- Yuji Takayama
- Nao Kakizawa
- Yuta Muto
- Fumi Hasegawa
- Fumiaki Watanabe
- Rina Kikugawa
- Masaaki Saito
- Shingo Tsujinaka
- Yasuyuki Miyakura
- Toshiki Rikiyama
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Affiliations: Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Saitama 330‑8503, Japan
Published online on: April 26, 2017 https://doi.org/10.3892/ol.2017.6100
Pages: 4947-4952

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Abstract

Sequential administration of the chemotherapy regimes capecitabine and oxaliplatin (XELOX) and capecitabine and irinotecan (XELIRI) in the first‑ to second‑line treatment setting would allow patients to be managed more easily in an outpatient unit. However, a small number of studies have raised concerns of cumulative adverse events as a consequence of the continuous use of capecitabine. To investigate this, the present study conducted a retrospective review of 81 consecutive metastatic colorectal cancer (mCRC) patients treated with the oxaliplatin, fluorouracil and leucovorin-irinotecan, fluorouracil and leucovorin (FOLFOX‑FOFIRI/F‑F) regimen (n=40) or the XELOX‑XELIRI (X‑X) regimen (n=41) in first‑ to second‑line chemotherapy in Saitama Medical Center between 2006 and 2012. The disease control rate (DCR), the progression free survival (PFS), the overall survival (OS) and the time to failure of strategy (TFS) from first to second‑line chemotherapy, as well as adverse events, were assessed and compared between patients receiving X‑X or F‑F. A total of 10 and 20 patients were additionally treated with bevacizumab in the F‑F and X‑X regimens, respectively, during first or second‑line chemotherapy. There was no significant difference in DCR and the median PFS between the two regimens for first or second‑line chemotherapy. There was no significant difference in the median OS and TFS between the two regimens (OS=24.5 and TFS=14 months in the F‑F vs. 23.2 and 12.0 months in the X‑X). Regarding adverse events, 45.0% of patients (18/40) exhibited grade 3‑4 neutropenia throughout treatment with F‑F. Whilst, 15.0% of patients (6/41) exhibited grade 3 hypertension throughout treatment with X‑X, which was effectively controlled by a single antihypertensive drug. The results show that sequential administration of X‑X is as effective and feasible as F‑F treatment, while additionally reducing the frequency of infusion visits and eliminating the need for a central venous access device or home infusion pump, thereby offering a more convenient treatment option to patients with mCRC.

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