title: Reduced-intensity FOLFOXIRI in Treating Refractory Metastatic Colorectal Cancer: A Pilot Study.
abstract: OBJECTIVE
  To report on the efficacy and safety of reduced-intensity FOLFOXIRI (RI-FOLFOXIRI) as salvage chemotherapy for patients with refractory metastatic colorectal cancer (mCRC).
  
  
  METHODS
  From October 2009 to March 2014, a total of 45 patients with refractory mCRC received RI-FOLFOXIRI as salvage chemotherapy. The initial dose of RI-FOLFOXIRI was 85% of the dose last used for each drug. All patients received a 2-hour infusion of folinate, followed by a bolus of 5-fluorouracil, and then 2400 to 3000 mg/m for 46 hours; in addition, patients were either administered irinotecan on day 1 followed by oxaliplatin on day 3 (group A), oxaliplatin on day 1 followed by irinotecan on day 3 (group B), or irinotecan and oxaliplatin on day 1 (group C).
  
  
  RESULTS
  Seven patients (15.6%) showed a partial response, and 15 patients (33.3%) had stable disease. The median progression-free and overall survival durations were 3.9 and 7.6 months, respectively. Patients who had wild-type K-RAS showed a longer overall survival duration (8.5 vs. 7.0 mo; P=0.04) but no difference in progression-free survival durations (4.4 vs. 3.4 mo; P=0.20) compared with patients with mutant K-RAS. The most common adverse events were neutropenia (28.9%) and diarrhea (26.7%).
  
  
  CONCLUSIONS
  RI-FOLFOXIRI as salvage chemotherapy is effective and enables management of patients with refractory mCRC.
authors.affiliation: *Department of Medicine, Division of Hematology and Oncology, Taoyuan Armed Forces General Hospital, Taoyuan County Departments of †Medicine, Division of Hematology and Oncology ‡Surgery, Division of Colon and Rectum Surgery, Taipei Veterans General Hospital §School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.
authors.forename: Hung-Ming
authors.initials: HM
authors.lastname: Chen
authors.forename: Jen-Kou
authors.initials: JK
authors.lastname: Lin
authors.forename: Wei-Shone
authors.initials: WS
authors.lastname: Chen
authors.forename: Jeng-Kai
authors.initials: JK
authors.lastname: Jiang
authors.forename: Shung-Haur
authors.initials: SH
authors.lastname: Yang
authors.forename: Yuan-Tzu
authors.initials: YT
authors.lastname: Lan
authors.forename: Chun-Chi
authors.initials: CC
authors.lastname: Lin
authors.forename: Hao-Wei
authors.initials: HW
authors.lastname: Teng
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000235:genetics / Q000556:secondary; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000009:adverse effects; D002166:Camptothecin / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology; D003967:Diarrhea / Q000139:chemically induced; D018572:Disease-Free Survival; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009154:Mutation; D009503:Neutropenia / Q000139:chemically induced; D009944:Organoplatinum Compounds / Q000008:administration & dosage / Q000009:adverse effects; D010865:Pilot Projects; D016283:Proto-Oncogene Proteins p21(ras) / Q000235:genetics; D066066:Response Evaluation Criteria in Solid Tumors; D012189:Retrospective Studies; D016879:Salvage Therapy; D015996:Survival Rate
chemical_list: C117307:KRAS protein, human; D009944:Organoplatinum Compounds; D016283:Proto-Oncogene Proteins p21(ras); D002955:Leucovorin; D005472:Fluorouracil; D002166:Camptothecin