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International Journal of Clinical Oncology
Published in: International Journal of Clinical Oncology 5/2019

01-05-2019 | Bevacizumab | Original Article

Efficacy and safety of ramucirumab plus modified FOLFIRI for metastatic colorectal cancer

Authors: Tomoyasu Yoshihiro, Hitoshi Kusaba, Akitaka Makiyama, Kazuma Kobayashi, Masato Uenomachi, Mamoru Ito, Yasuhiro Doi, Kenji Mitsugi, Tomomi Aikawa, Kotoe Takayoshi, Taito Esaki, Hozumi Shimokawa, Kenji Tsuchihashi, Hiroshi Ariyama, Koichi Akashi, Eishi Baba

Published in: International Journal of Clinical Oncology | Issue 5/2019

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Abstract

Background

Dose modification of chemotherapy for metastatic colorectal cancer (MCRC) is often needed, especially in second-line and later-line treatments due to adverse events of previous treatment and poor patient condition. No study has focused on ramucirumab plus modified dose of FOLFIRI for MCRC, and whether low relative dose intensity (RDI) affects treatment efficacy has not been clarified.

Methods

MCRC patients who received ramucirumab plus FOLFIRI, which consisted of 150 mg/m2 of irinotecan, at six institutions were retrospectively analyzed.

Results

A total of 43 patients were assessed. Median age was 63 years, and 22 patients (51%) were women. Twenty-six patients (60%) were given ramucirumab plus FOLFIRI as second-line therapy, and 17 (40%) as third or later-line. The median relative dose intensity (RDI) of irinotecan was 60.6%, which is lower than that in the pivotal phase 3 study (RAISE), and other agents showed the same trend. Median progression-free survival was 4.8 [95% confidence interval (CI) 3.2–5.7] months for all patients, 5.4 (95% CI 3.5–7.2) months for second-line patients, and 2.8 (95% CI 1.6–5.8) months for third or later-line patients. Median overall survival was 17.3 (95% CI 11.5–22.4) months for all patients. Patients with irinotecan RDI less than 60% showed similar treatment efficacy. Hematological toxicities of grade 3 or worse were observed in 21 patients, but all were manageable.

Conclusion

Low RDI did not compromise the treatment efficacy of ramucirumab plus modified FOLFIRI for MCRC patients.
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Metadata
Title
Efficacy and safety of ramucirumab plus modified FOLFIRI for metastatic colorectal cancer
Authors
Tomoyasu Yoshihiro
Hitoshi Kusaba
Akitaka Makiyama
Kazuma Kobayashi
Masato Uenomachi
Mamoru Ito
Yasuhiro Doi
Kenji Mitsugi
Tomomi Aikawa
Kotoe Takayoshi
Taito Esaki
Hozumi Shimokawa
Kenji Tsuchihashi
Hiroshi Ariyama
Koichi Akashi
Eishi Baba
Publication date
01-05-2019
Publisher
Springer Singapore
Published in
International Journal of Clinical Oncology / Issue 5/2019
Print ISSN: 1341-9625
Electronic ISSN: 1437-7772
DOI
https://doi.org/10.1007/s10147-018-01391-w

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