title: Rechallenge with oxaliplatin and fluoropyrimidine for metastatic colorectal carcinoma after prior therapy.
abstract: OBJECTIVE
  Patients with advanced colorectal cancer (CRC) who have received oxaliplatin, 5-fluoropyrimidine, and irinotecan chemotherapy (with or without bevacizumab) and antiepidermal growth factor receptor therapy (if KRAS is wild type) have no further standard treatment options. Although repeating a prior chemotherapy [in particular, oxaliplatin and fluoropyrimidine (FOX)] is an option, there is very little evidence in the literature for this approach; thus, we reviewed our registry to assess the frequency and outcome of rechallenging with FOX.
  
  
  METHODS
  Patients who had been rechallenged with FOX were identified from the South Australian metastatic CRC database. Patient characteristics were analyzed, and tumor response was retrospectively assessed using Response Evaluation Criteria in Solid Tumors criteria.
  
  
  RESULTS
  Twenty patients were eligible for inclusion in this analysis. The number of prior lines of therapy received for metastatic CRC was 4 lines for 2 patients, 3 lines for 6 patients, 2 lines for 7 patients, and 1 line for 3 patients, with 3 patients having received oxaliplatin as adjuvant therapy. Four patients had received bevacizumab previously, 7 patients had undergone antiepidermal growth factor receptor treatment, and 4 patients had undergone liver resection earlier. Response rate was 18%, and 47% had stable disease. The median progression-free survival was 3.7 months, median overall survival was 7.8 months, and 1-year survival was 37%.
  
  
  CONCLUSIONS
  In this selected population, there is evidence of modest activity of rechallenge with FOX chemotherapy, although radiologic response is uncommon.
authors.affiliation: Department of Haematology-Oncology, The Queen Elizabeth Hospital, Woodville, Australia.
authors.forename: Amanda R
authors.initials: AR
authors.lastname: Townsend
authors.forename: Sarwan
authors.initials: S
authors.lastname: Bishnoi
authors.forename: Vy
authors.initials: V
authors.lastname: Broadbridge
authors.forename: Carol
authors.initials: C
authors.lastname: Beeke
authors.forename: Christos S
authors.initials: CS
authors.lastname: Karapetis
authors.forename: Kunal
authors.initials: K
authors.lastname: Jain
authors.forename: Colin
authors.initials: C
authors.lastname: Luke
authors.forename: Robert
authors.initials: R
authors.lastname: Padbury
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Price
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000401:mortality*; D018572:Disease-Free Survival; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D053208:Kaplan-Meier Estimate; D009944:Organoplatinum Compounds / Q000008:administration & dosage / Q000009:adverse effects; D000077150:Oxaliplatin; D012189:Retrospective Studies; D016879:Salvage Therapy / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D005472:Fluorouracil