Researchers at Asan Medical Center (AMC) have found a more effective and safe combination treatment formula in treating colorectal cancer, the hospital said Thursday.
According to the World Health Organization (WHO), colorectal cancer is the third most common cancer in the world. The survival rate of metastatic colorectal cancer has steadily improved, but the average survival time is still only two years. Such low survival rate has continuously highlighted the need for new chemotherapy, which is more effective than the conventional cancer therapy with fewer side effects.
The research team, led by Professor Kim Tae-won of the department of oncology at the hospital, conducted a trial in 650 patients with metastatic colorectal cancer, who had finished their first chemotherapy, at 98 hospitals in Korea, Japan and China from December 2013 to August 2015. The team randomly injected either the new combination therapy (mXELIRI + bevacizumab) or the conventional treatment (FOLFIRI + bevacizumab).
There was no difference in the survival rate between the two chemotherapy regimens, but the new treatment significantly reduced the chemotherapy adverse events.
Over the average follow-up period of 15.8 months, the team recorded an overall survival time of 16.8 months for mXELIRI treatment group, which was slightly higher than that of FOLFIRI group’s 15.4 months.
Also, the incidence of serious adverse events greater than Class 3 in patients was 54 percent in the mXELIRI group, which was significantly less than the 72 percent recorded in the FOLFIRI group.
The trial also showed that neutropenia (leukocytosis), the most common adverse effect of anticancer drugs, was 16.8 percent in groups treated with mXELIRI compared to the 42.9 percent recorded in the conventional therapy group.
The mXELIRI (modified XELIRI) regimen studied by the AMC team is a modification of the XELIRI regimen, which is known to be toxic. XELIRI, a method of administering both capecitabine oral anticancer drug and irinotecan injection chemotherapy, is convenient as it does not require hospital admission and the need for direct insertion into the central vein. However, due to the toxicity of anticancer drugs, it is not recommended.
The modified mXELIRI regimen changed the method of administration of anticancer drugs. On the first day of chemotherapy, the medical staff injected 200mg/m² of irinotecan for two hours. Afterward, the team orally administered 1600 mg/m² capecitabine for two weeks and took a three-week resting period.
The conventional method injected irinotecan and fluorouracil, which are anticancer drugs for colon cancer, directly into the central vein. It was also inconvenient as it required hospital admission.
“The study was the first of its kind to demonstrate that mXELIRI therapy has the same therapeutic efficacy and fewer side effects when compared to the conventional method,” Professor Kim said. “The treatment can become a new convenient and safe option for patients, who do not want hospitalization or the drug administered directly into their central vein.”
Lancet Oncology published the results of the study in its latest issue.