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Published in: Journal of Cancer Research and Clinical Oncology 1/2015

01-01-2015 | Original Article – Clinical Oncology

A phase 3 non-inferiority study of 5-FU/l-leucovorin/irinotecan (FOLFIRI) versus irinotecan/S-1 (IRIS) as second-line chemotherapy for metastatic colorectal cancer: updated results of the FIRIS study

Authors: Hirofumi Yasui, Kei Muro, Yasuhiro Shimada, Akihito Tsuji, Shinichi Sameshima, Hideo Baba, Taroh Satoh, Tadamichi Denda, Kenji Ina, Tomohiro Nishina, Kensei Yamaguchi, Taito Esaki, Shinya Tokunaga, Hiroyuki Kuwano, Narikazu Boku, Yoshito Komatsu, Masahiko Watanabe, Ichinosuke Hyodo, Satoshi Morita, Kenichi Sugihara

Published in: Journal of Cancer Research and Clinical Oncology | Issue 1/2015

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Abstract

Purpose

The FIRIS study previously demonstrated non-inferiority of IRIS (irinotecan plus S-1) to FOLFIRI (5-fluorouracil/leucovorin with irinotecan) for progression-free survival as the second-line chemotherapy for metastatic colorectal cancer (mCRC) as the primary endpoint. The overall survival (OS) data were immature at the time of the primary analysis.

Methods

Between 30 January 2006 and 29 January 2008, 426 patients with mCRC who failed in first-line chemotherapy were randomly assigned to receive either FOLFIRI or IRIS. After the primary analysis, the follow-up survey was cut off on 29 July 2010, and the final OS data were analysed.

Results

With a median follow-up of 39.2 months, the median OS was 17.4 months in the FOLFIRI group and 17.8 months in the IRIS group [hazard ratio (HR) 0.900; 95 % confidence interval (CI) 0.728–1.112]. In the pre-planned subgroup of patients who received prior chemotherapy containing oxaliplatin, the median OS was 12.7 months in the FOLFIRI group and 15.3 months in the IRIS group (HR 0.755; 95 % CI 0.580–0.983).

Conclusions

IRIS is non-inferior to FOLFIRI for OS as second-line chemotherapy for mCRC. IRIS can be an option for second-line chemotherapy of mCRC. (ClinicalTrials.gov Number: NCT00284258).
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Literature
go back to reference Baba H, Watanabe M, Okabe H et al (2012) Upregulation of ERCC1 and DPD expressions after oxaliplatin-based first-line chemotherapy for metastatic colorectal cancer. Br J Cancer 107:1950–1955PubMedCentralPubMedCrossRef Baba H, Watanabe M, Okabe H et al (2012) Upregulation of ERCC1 and DPD expressions after oxaliplatin-based first-line chemotherapy for metastatic colorectal cancer. Br J Cancer 107:1950–1955PubMedCentralPubMedCrossRef
go back to reference Brookmeyer R, Crowley J (1982) A confidence interval for the median survival time. Biometrics 38:29–41CrossRef Brookmeyer R, Crowley J (1982) A confidence interval for the median survival time. Biometrics 38:29–41CrossRef
go back to reference Fuse N, Doi T, Ohtsu A et al (2008) Safety of irinotecan and infusional fluorouracil/leucovorin (FOLFIRI) in Japan: a retrospective review of 48 patients with metastatic colorectal cancer. Int J Clin Oncol 13:144–149PubMedCrossRef Fuse N, Doi T, Ohtsu A et al (2008) Safety of irinotecan and infusional fluorouracil/leucovorin (FOLFIRI) in Japan: a retrospective review of 48 patients with metastatic colorectal cancer. Int J Clin Oncol 13:144–149PubMedCrossRef
go back to reference Goto A, Yamada Y, Yasui H et al (2006) Phase II study of combination therapy with S-1 and irinotecan in patients with advanced colorectal cancer. Ann Oncol 17:968–973PubMedCrossRef Goto A, Yamada Y, Yasui H et al (2006) Phase II study of combination therapy with S-1 and irinotecan in patients with advanced colorectal cancer. Ann Oncol 17:968–973PubMedCrossRef
go back to reference Komatsu Y, Yuki S, Fuse N et al (2010) Phase 1/2 clinical study of irinotecan and oral S-1 (IRIS) in patients with advanced gastric cancer. Adv Ther 27:483–492PubMedCrossRef Komatsu Y, Yuki S, Fuse N et al (2010) Phase 1/2 clinical study of irinotecan and oral S-1 (IRIS) in patients with advanced gastric cancer. Adv Ther 27:483–492PubMedCrossRef
go back to reference Komatsu Y, Yuki S, Sogabe S et al (2011) Phase II study of combined treatment with irinotecan and S-1 (IRIS) in patients with inoperable or recurrent advanced colorectal cancer (HGCSG0302). Oncology 80:70–75PubMedCrossRef Komatsu Y, Yuki S, Sogabe S et al (2011) Phase II study of combined treatment with irinotecan and S-1 (IRIS) in patients with inoperable or recurrent advanced colorectal cancer (HGCSG0302). Oncology 80:70–75PubMedCrossRef
go back to reference Muro K, Boku N, Shimada Y et al (2010) Irinotecan plus S-1 (IRIS) versus fluorouracil and folinic acid plus irinotecan (FOLFIRI) as second-line chemotherapy for metastatic colorectal cancer: a randomised phase 2/3 non-inferiority study (FIRIS study). Lancet Oncol 11:853–860PubMedCrossRef Muro K, Boku N, Shimada Y et al (2010) Irinotecan plus S-1 (IRIS) versus fluorouracil and folinic acid plus irinotecan (FOLFIRI) as second-line chemotherapy for metastatic colorectal cancer: a randomised phase 2/3 non-inferiority study (FIRIS study). Lancet Oncol 11:853–860PubMedCrossRef
go back to reference O’Neil BH, Goldberg RM (2008) Innovations in chemotherapy for metastatic colorectal cancer: an update of recent clinical trials. The Oncol 13:1074–1083CrossRef O’Neil BH, Goldberg RM (2008) Innovations in chemotherapy for metastatic colorectal cancer: an update of recent clinical trials. The Oncol 13:1074–1083CrossRef
go back to reference Peeters M, Price TJ, Cervantes A et al (2010) Randomized phase III study of panitumumab with fluorouracil, leucovorin, and irinotecan (FOLFIRI) compared with FOLFIRI alone as second-line treatment in patients with metastatic colorectal cancer. J Clin Oncol 28:4706–4713PubMedCrossRef Peeters M, Price TJ, Cervantes A et al (2010) Randomized phase III study of panitumumab with fluorouracil, leucovorin, and irinotecan (FOLFIRI) compared with FOLFIRI alone as second-line treatment in patients with metastatic colorectal cancer. J Clin Oncol 28:4706–4713PubMedCrossRef
go back to reference Schmoll HJ, Van Cutsem E, Stein A et al (2012) ESMO Consensus Guidelines for management of patients with colon and rectal cancer. a personalized approach to clinical decision making. Ann Oncol 23:2479–2516PubMedCrossRef Schmoll HJ, Van Cutsem E, Stein A et al (2012) ESMO Consensus Guidelines for management of patients with colon and rectal cancer. a personalized approach to clinical decision making. Ann Oncol 23:2479–2516PubMedCrossRef
go back to reference Shiozawa M, Akaike M, Sugano N et al (2010) A phase II study of combination therapy with irinotecan and S-1 (IRIS) in patients with advanced colorectal cancer. Cancer Chemother Pharmacol 66:987–992PubMedCrossRef Shiozawa M, Akaike M, Sugano N et al (2010) A phase II study of combination therapy with irinotecan and S-1 (IRIS) in patients with advanced colorectal cancer. Cancer Chemother Pharmacol 66:987–992PubMedCrossRef
go back to reference Sobrero AF, Maurel J, Fehrenbacher L et al (2008) EPIC: phase III trial of cetuximab plus irinotecan after fluoropyrimidine and oxaliplatin failure in patients with metastatic colorectal cancer. J Clin Oncol 26:2311–2319PubMedCrossRef Sobrero AF, Maurel J, Fehrenbacher L et al (2008) EPIC: phase III trial of cetuximab plus irinotecan after fluoropyrimidine and oxaliplatin failure in patients with metastatic colorectal cancer. J Clin Oncol 26:2311–2319PubMedCrossRef
go back to reference Spiegelhalter DJ, Freedman LS, Parmar MKB (1994) Bayesian approaches to randomized trials. J R Stat Soc 157:357–387CrossRef Spiegelhalter DJ, Freedman LS, Parmar MKB (1994) Bayesian approaches to randomized trials. J R Stat Soc 157:357–387CrossRef
go back to reference Tournigand C, André T, Achille E et al (2004) FOLFIRI followed by FOLFOX6 or the reverse sequence in advanced colorectal cancer: a randomized GERCOR study. J Clin Oncol 22:229–237PubMedCrossRef Tournigand C, André T, Achille E et al (2004) FOLFIRI followed by FOLFOX6 or the reverse sequence in advanced colorectal cancer: a randomized GERCOR study. J Clin Oncol 22:229–237PubMedCrossRef
go back to reference Tsunoda A, Yasuda N, Nakao K et al (2009) Phase II study of S-1 combined with irinotecan (CPT-11) in patients with advanced colorectal cancer. Oncology 77:192–196PubMedCrossRef Tsunoda A, Yasuda N, Nakao K et al (2009) Phase II study of S-1 combined with irinotecan (CPT-11) in patients with advanced colorectal cancer. Oncology 77:192–196PubMedCrossRef
Metadata
Title
A phase 3 non-inferiority study of 5-FU/l-leucovorin/irinotecan (FOLFIRI) versus irinotecan/S-1 (IRIS) as second-line chemotherapy for metastatic colorectal cancer: updated results of the FIRIS study
Authors
Hirofumi Yasui
Kei Muro
Yasuhiro Shimada
Akihito Tsuji
Shinichi Sameshima
Hideo Baba
Taroh Satoh
Tadamichi Denda
Kenji Ina
Tomohiro Nishina
Kensei Yamaguchi
Taito Esaki
Shinya Tokunaga
Hiroyuki Kuwano
Narikazu Boku
Yoshito Komatsu
Masahiko Watanabe
Ichinosuke Hyodo
Satoshi Morita
Kenichi Sugihara
Publication date
01-01-2015
Publisher
Springer Berlin Heidelberg
Published in
Journal of Cancer Research and Clinical Oncology / Issue 1/2015
Print ISSN: 0171-5216
Electronic ISSN: 1432-1335
DOI
https://doi.org/10.1007/s00432-014-1783-3

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