title: Patients with Metastatic Colorectal Cancer and Hyperbilirubinemia Treated with FOLFIRI plus Bevacizumab as First-Line Treatment.
abstract: Metastatic colorectal cancer (mCRC) combined with hyperbilirubinemia is typically considered a contraindication to irinotecan-based therapy, a proven first-line treatment of mCRC. Herein, we present 6 consecutive patients with mCRC combined with hyperbilirubinemia who underwent UGT1A1 genotyping before receiving FOLFIRI plus bevacizumab. Dose escalation of irinotecan was performed according to the results of UGT1A1 genotyping in all patients. Improvement in the serum total bilirubin level to a normal range was noted in all 6 patients. Disease control was 100%. The median progression-free survival was 7.5 months and the median overall survival was 8.5 months. FOLFIRI plus bevacizumab as a first-line chemotherapy may achieve effective disease control and be safe in patients with mCRC and hyperbilirubinemia based on UGT1A1 genotyping. More prospective clinical studies are necessary to evaluate the clinical benefits and safety of this treatment approach.
authors.affiliation: Division of Gastroenterology and General Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC.
authors.forename: Ching-Wen
authors.initials: CW
authors.lastname: Huang
authors.forename: Yung-Sung
authors.initials: YS
authors.lastname: Yeh
authors.forename: Cheng-Jen
authors.initials: CJ
authors.lastname: Ma
authors.forename: Hsiang-Lin
authors.initials: HL
authors.lastname: Tsai
authors.forename: Chao-Wen
authors.initials: CW
authors.lastname: Chen
authors.forename: Ming-Yii
authors.initials: MY
authors.lastname: Huang
authors.forename: Chien-Yu
authors.initials: CY
authors.lastname: Lu
authors.forename: Jeng-Yih
authors.initials: JY
authors.lastname: Wu
authors.forename: Jaw Yuan
authors.initials: JY
authors.lastname: Wang
mesh_terms: D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D000068258:Bevacizumab / Q000008:administration & dosage*; D001663:Bilirubin / Q000097:blood; D001859:Bone Neoplasms / Q000556:secondary; D002166:Camptothecin / Q000031:analogs & derivatives* / Q000627:therapeutic use; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000473:pathology; D018572:Disease-Free Survival; D005472:Fluorouracil / Q000627:therapeutic use; D005838:Genotype; D014453:Glucuronosyltransferase / Q000235:genetics; D006801:Humans; D006932:Hyperbilirubinemia / Q000175:diagnosis; D002955:Leucovorin / Q000627:therapeutic use; D008113:Liver Neoplasms / Q000556:secondary; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015996:Survival Rate; D000099148:UGT1A1 Enzyme
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D001663:Bilirubin; D002166:Camptothecin; D005472:Fluorouracil; D014453:Glucuronosyltransferase; D002955:Leucovorin; D000099148:UGT1A1 Enzyme