title: Phase II Study of Biweekly Pemetrexed Plus Irinotecan as Second-Line Therapy for Metastatic Colorectal Cancer.
abstract: Background. This open-label, single-arm, two-stage, Phase II study investigated the efficacy and safety of bi-weekly pemetrexed combined with irinotecan, in patients with metastatic colorectal cancer (mCRC), after first-line chemotherapy using FOLFOX regimen. Patients and methods. Patients received pemetrexed 400 mg/m(2) as a 10-minute intravenous infusion (with vitamin supplementation) followed by irinotecan 180 mg/m(2) as a 90-minute infusion on day 1 of a 14-day cycle, for a maximum of 12 cycles. The primary endpoint was response rate (RR; H(0) </= 5%, H(a) >/= 20%, alpha = 0.05, power = 90%). Secondary endpoints were duration of response, progression-free survival (PFS), overall survival (OS), and toxicities. Results. Partial response was observed in six out of 44 patients enrolled in the study (RR = 13.6%). The median PFS and OS were 4.0 and 13.9 months, respectively. The most common grade 3-4 toxicities were fatigue: 20.5% of patients, neutropenia: 18.6%, diarrhea: 13.6%, elevated transaminases: 9.5%, anemia: 9.3%, and vomiting: 6.8%. Conclusion. Pemetrexed plus irinotecan administered every two weeks is an active and well-tolerated regimen in mCRC patients pretreated with FOLFOX regimen. However, this regimen does not seem to provide clinically relevant advantage over historical data of a classical FOLFIRI regimen.
authors.affiliation: Service d'Oncologie, Hôpital Saint-Antoine, 184 rue du Faubourg Saint-Antoine, 75012 Paris, France.
authors.forename: C
authors.initials: C
authors.lastname: Louvet
authors.forename: T
authors.initials: T
authors.lastname: André
authors.forename: E
authors.initials: E
authors.lastname: Gamelin
authors.forename: M
authors.initials: M
authors.lastname: Hebbar
authors.forename: M
authors.initials: M
authors.lastname: Mabro
authors.forename: M
authors.initials: M
authors.lastname: Bennamoun
authors.forename: H
authors.initials: H
authors.lastname: Rassam
authors.forename: A
authors.initials: A
authors.lastname: de Gramont
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