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Phase I/II study of sequential therapy with irinotecan and S-1 for metastatic colorectal cancer.

AbstractBACKGROUND:
Both irinotecan (CPT-11) and S-1 are active against colorectal cancer; however, as S-1 is a prodrug of 5-fluorouracil (5-FU), 5-FU and its metabolites might inhibit the antitumour effect of CPT-11. Therefore, we designed a sequential combination, in which CPT-11 infusion was given on day 1 and S-1 was given orally at 80 mg m(-2) per day on days 3-16 every 3 weeks.
METHODS:
Twelve patients entered the phase I study, and the recommended doses were determined as a CPT-11 dose of 150 mg m(-2) and an S-1 dose of 80 mg m(-2).
RESULTS:
In all, 36 patients entered the phase II study, of whom 4 and 16 had complete and partial responses. The overall response rate was 55.6% (95% confidence interval, 38.1-72.1%), and median progression-free survival was 7.7 months (95% confidence interval, 4.8-12.6 months). Grade 3 neutropenia was the most common haematological toxicity and occurred in 6.5% of 215 treatment courses. Grade 3 non-haematological toxicities included anorexia (1.4%) and diarrhoea (0.9%). There was no grade 4 toxicity of any kind.
CONCLUSION:
Our results suggest that this regimen is convenient, safe and promising, compared with conventional regimens for patients with metastatic colorectal cancer.
AuthorsT Yoshioka, S Kato, M Gamoh, N Chiba, T Suzuki, N Sakayori, S Kato, H Shibata, H Shimodaira, K Otsuka, Y Kakudo, S Takahashi, C Ishioka
JournalBritish journal of cancer (Br J Cancer) Vol. 101 Issue 12 Pg. 1972-7 (Dec 15 2009) ISSN: 1532-1827 [Electronic] England
PMID19920821 (Publication Type: Clinical Trial, Phase I, Clinical Trial, Phase II, Journal Article)
Chemical References
  • Drug Combinations
  • S 1 (combination)
  • Tegafur
  • Oxonic Acid
  • Irinotecan
  • Camptothecin
Topics
  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
  • Camptothecin (administration & dosage, adverse effects, analogs & derivatives)
  • Colorectal Neoplasms (drug therapy)
  • Drug Combinations
  • Female
  • Humans
  • Irinotecan
  • Male
  • Maximum Tolerated Dose
  • Middle Aged
  • Oxonic Acid (administration & dosage, adverse effects)
  • Tegafur (administration & dosage, adverse effects)

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