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Use of the folinic acid/5-fluorouracil/irinotecan (FOLFIRI 1) regimen in elderly patients as a first-line treatment for metastatic colorectal cancer: a Phase II study

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Abstract

Background

The aim of this study was to evaluate the effects of a combination of folinic acid, 5-fluorouracil (5FU) and irinotecan (FOLFIRI 1) administered every 2 weeks in a population of elderly subjects with advanced colorectal cancer.

Patients and methods

Patients with metastatic colorectal cancer included in this study were aged at least 70 years, with a performance status of 0/1, without geriatric syndrome and without previous palliative chemotherapy. They received irinotecan [180 mg/m2 intravenous (iv) infusion over 90 min] followed by folinic acid (400 mg/m2 iv over 2 h), then 5FU (400 mg/m2 iv bolus) and 5FU (2,400 mg/m2 continuous iv infusion for 46 h) every 2 weeks.

Results

Forty eligible patients were included. The median age was 77.3 years (range 70–84.7). The objective response rate was 40% and the stabilisation rate was 45%. Median progression-free survival was 8 months, overall survival was 17.2 months and cancer-related specific survival was 20.2 months. In total, 300 cycles of chemotherapy were administered with a median number of eight cycles per patient (range 1–18). Tolerance was good; grade 3/4 toxicities included diarrhoea (15%), asthenia (15%), nausea/vomiting (7.5%) and neutropenia (7.5%). One toxic death was observed due to grade 4 diarrhoea.

Conclusion

The FOLFIRI 1 regimen is a valid therapeutic option for elderly patients in good clinical condition.

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References

  1. Fried L (2003) Establishing benchmarks for quality care for an aging population: caring for vulnerable older adults. Ann Int Med 139:784–786

    PubMed  Google Scholar 

  2. Hayat MJ, Howlader N, Reichman ME, Edwards BK (2007) Cancer statistics, trends, and multiple primary cancer analyses from the surveillance, epidemiology, and end results (SEER) program. Oncologist 12:20–37

    Article  PubMed  Google Scholar 

  3. Gatta G, Faivre J, Capocaccia R et al (1998) Survival of colorectal cancer patients in Europe during period 1978–1989: the EUROCARE working group. Eur J Cancer 34:2176–2183

    Article  CAS  Google Scholar 

  4. Douillard JY, Cunningham D, Roth AD et al (2000) Irinotecan combined with fluorouracil compared with fluorouracil alone as first-line treatment for metastatic colorectal cancer: a multicentre randomized trial. Lancet 355:1041–1047

    Article  PubMed  CAS  Google Scholar 

  5. Saltz LB, Cox JV, Blanke C et al (2000) Irinotecan plus fluorouracil and leucovorin for metastatic colorectal cancer. N Engl J Med 343:905–914

    Article  PubMed  CAS  Google Scholar 

  6. de Gramont A, Figer A, Seymour M et al (2000) Leucovorin and fluorouracil with or without oxaliplatin as first-line treatment in advanced colorectal cancer. J Clin Oncol 18:2938–2947

    PubMed  Google Scholar 

  7. Sargent D, Goldberg R, Jacobson S et al (2001) A pooled analysis of adjuvant chemotherapy for resected colon cancer in elderly patients. N Engl J Med 345:1091–1097

    Article  PubMed  CAS  Google Scholar 

  8. Magne N, Francois E, Broisin L et al (2002) Palliative 5-fluorouracil-based chemotherapy for advanced colorectal cancer in the elderly. Am J Clin Oncol 25:126–130

    Article  PubMed  Google Scholar 

  9. Köhne CH, van Cutsem E, Wils J et al (2005) Phase III study of weekly high-dose infusional fluorouracil plus folinic acid with or without irinotecan in patients with metastatic colorectal cancer: European organisation for research and treatment of cancer gastrointestinal group study 40986. J Clin Oncol 23:4856–4865

    Article  PubMed  Google Scholar 

  10. Andre T, Louvet C, Maindrault-Goebel F et al (1999) CPT-11 (irinotecan) addition to bimonthly, high-dose leucovorin and continuous infusion 5-fluorouracil (FOLFIRI) for pretreated metastatic colorectal cancer. Eur J Cancer 35:1343–1347

    Article  PubMed  CAS  Google Scholar 

  11. Mitry E, Tournigand C, Andre T et al (2004) Comparison of the tolerance and efficacy of LV5FU2-CPT11 and FOLFIRI regimens in front-line treatment of advanced colorectal cancer––a pooled analysis of 254 patients included in 2 randomised trials. J Clin Oncol 22:14s. a 3576

    Google Scholar 

  12. Therasse P, Arbuck SG, Eisenhauer EA et al (2000) New guidelines to evaluate the treatment in solid tumors. J Natl Cancer Inst 3:205–216

    Article  Google Scholar 

  13. Conwell Y, Forbes NT, Cox C, Caine ED (1993) Validation of a measure of physical illness burden at autopsy: the cumulative illness rating scale. J Am Geriatr Soc 41:38–41

    PubMed  CAS  Google Scholar 

  14. Spitzer WO, Dobson AJ, Hall J et al (1981) Measuring the quality of life of cancer patients: a concise QL-index for use by physicians. J Chronic Dis 34:585–597

    Article  PubMed  CAS  Google Scholar 

  15. Fleming TR (1982) One sample multiple testing procedure for phase II clinical trials. Biometrics 38:143–151

    Article  PubMed  CAS  Google Scholar 

  16. Tournigand C, Andre 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 22:229–237

    Article  PubMed  CAS  Google Scholar 

  17. Grothey A, Sargent D, Goldberg R, Schmoll H-J (2004) Survival of patients with advanced colorectal cancer improves with the availability of fluorouracil-leucovorin, irinotecan, and oxaliplatin in the course of treatment. J Clin Oncol 22:1209–1214

    Article  PubMed  CAS  Google Scholar 

  18. Aparicio T, Desrame J, Lecomte T et al (2003) Oxaliplatin- or irinotecan-based chemotherapy for metastatic colorectal cancer in the elderly. Br J Cancer 89:1439–1444

    Article  PubMed  CAS  Google Scholar 

  19. Souglakos J, Pallis A, Kakolyris S et al (2005) Combination of irinotecan (CPT-11) plus 5-Fluorouracil and leucovorin (FOLFIRI Regimen) as first line treatment for elderly patients with metastatic colorectal cancer: a phase II trial. Oncology 69:384–390

    Article  PubMed  CAS  Google Scholar 

  20. Sastre J, Marcuello E, Masutti B et al (2005) Irinotecan in combination with fluorouracil in a 48-hour continuous infusion as first-line chemotherapy for elderly patients with metastatic colorectal cancer: a Spanish cooperative group for the treatment of digestive tumors study. J Clin Oncol 23:3545–3551

    Article  PubMed  CAS  Google Scholar 

  21. Comella P, Farris A, Lorusso V et al (2003) Irinotecan plus leucovorin-modulated 5-fluorouracil I.V. bolus every other week may be a suitable therapeutic option also for elderly patients with metastatic colorectal carcinoma. Br J Cancer 89:992–996

    Article  PubMed  CAS  Google Scholar 

  22. Balducci L, Extermann M (2000) Management of cancer in the older person: a practical approach. Oncologist 5:224–237

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Centre Antoine-Lacassagne, 33 Ave de Valombrose, 06189, Nice Cedex 2, France

    Eric François, Emmanuel Chamorey, Christophe Hébert & Véronique Mari

  2. Clinique de l’Espérance, Hyères, France

    Jean-François Berdah

  3. Clinique Saint-Laurent, Saint Laurent du Var, France

    Gérard Lesbats

  4. Clinique Plein Ciel, Mougins, France

    Eric Teissier

  5. Centre Hospitalier, Draguignan, France

    Jean-François Codoul

  6. Hôpital des Broussailles, Cannes, France

    Jean-Luc Badetti

Authors
  1. Eric François
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  2. Jean-François Berdah
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  3. Emmanuel Chamorey
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  4. Gérard Lesbats
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  5. Eric Teissier
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  6. Jean-François Codoul
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  7. Jean-Luc Badetti
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  8. Christophe Hébert
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  9. Véronique Mari
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Corresponding author

Correspondence to Eric François.

Additional information

This study was partly sponsored by Pfizer, Paris, France.

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François, E., Berdah, JF., Chamorey, E. et al. Use of the folinic acid/5-fluorouracil/irinotecan (FOLFIRI 1) regimen in elderly patients as a first-line treatment for metastatic colorectal cancer: a Phase II study. Cancer Chemother Pharmacol 62, 931–936 (2008). https://doi.org/10.1007/s00280-008-0681-2

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  • DOI: https://doi.org/10.1007/s00280-008-0681-2

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