Oxaliplatin rechallenge in metastatic colorectal cancer patients after prior oxaliplatin treatment.
Because the number of cytotoxic agents available for the treatment of metastatic colorectal cancer (mCRC) is limited, rechallenge with the same chemotherapy agents can provide a continuum of treatment. This study investigated the efficacy and feasibility of oxaliplatin rechallenge in mCRC patients who had been previously exposed to oxaliplatin-based chemotherapy. Patients were included if they had mCRC and evaluable disease, had remained disease-free or progression-free for at least 6 months after the last dose of prior oxaliplatin-based therapy, and were retreated with oxaliplatin therapy. Between January 2009 and May 2014, 110 patients were retreated with oxaliplatin-based regimens; of these, 42 (38.2%) had received prior oxaliplatin as adjuvant chemotherapy and 68 (61.8%) as palliative chemotherapy. The overall response rate to oxaliplatin rechallenge was 30.9% (34/110), and the disease control rate was 68.2% (75/110), with one patient achieving complete response, 33 achieving partial response, and 41 having stable disease. Median progression-free survival and overall survival following oxaliplatin rechallenge were 5.9 months (95% confidence interval [CI], 4.4-7.4 months) and 18.5 months (95% CI, 14.0-23.0 months), respectively. Sixteen patients experienced grade 2 or 3 neuropathy. Ten patients experienced any grade hypersensitivity reaction within four cycles of treatment, including six who stopped treatment due to grade 3 or 4 hypersensitivity reactions. Rechallenge with oxaliplatin-based therapy may be an option for patients who achieve at least 6 months of disease-free or progression-free survival with prior oxaliplatin-based chemotherapy. However, neurotoxicity and hypersensitivity reactions should be carefully monitored in this setting.
['Kim|Jae-Joon|JJ|', 'Kang|Jihoon|J|', 'Hong|Yong Sang|YS|', 'Kim|Kyu-Pyo|KP|', 'Kim|Sun Young|SY|', 'Kim|Tae Won|TW|', 'Kim|Jeong Eun|JE|']
D000328:Adult D000368:Aged D000369:Aged, 80 and over D000970:Antineoplastic Agents D000971:Antineoplastic Combined Chemotherapy Protocols D017024:Chemotherapy, Adjuvant D015179:Colorectal Neoplasms D018572:Disease-Free Survival D004342:Drug Hypersensitivity D005240:Feasibility Studies D005260:Female D006801:Humans D008297:Male D008875:Middle Aged D009362:Neoplasm Metastasis D009944:Organoplatinum Compounds D000077150:Oxaliplatin D012189:Retrospective Studies
Oxaliplatin Rechallenge Chemotherapy Metastatic colon cancer