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Annals of Oncology 15:1210-1214, 2004
© 2004 European Society for Medical Oncology

Oxaliplatin reintroduction in patients previously treated with leucovorin, fluorouracil and oxaliplatin for metastatic colorectal cancer

Background: FOLFOX, a bimonthly combination of leucovorin, 5-fluorouracil and oxaliplatin, is active in metastatic colorectal cancer, but sometimes causes cumulative sensory neurotoxicity. This retrospective study investigated FOLFOX reintroduction after a break in treatment or following disease progression on another regimen.

Patients and methods: FOLFOX was reintroduced in 29 patients. During their previous FOLFOX therapy, 24 had achieved a response, four were stable and one had progression. Median progression-free survival (PFS) was 33 weeks. Grade 3 neuropathy developed in nine and grade 2 neuropathy in eight patients.

Results: Following FOLFOX reintroduction, six patients (21%) showed a response, 15 (52%) were stable and eight (28%) had progression. Median PFS was 18 weeks. Grade 3 neuropathy developed in four patients and grade 2 neuropathy in 11. Two patients with previous grade 3 neuropathy had no recurrence of neuropathy after eight and 18 cycles, respectively. Among 13 patients who received no treatment between periods of FOLFOX therapy, four (31%) had a response and eight (62%) had stable disease.

Conclusion: Reintroduction of oxaliplatin was feasible and achieved a response or stabilization in 73% of patients. These results support the concept of intensified, repeated short courses of FOLFOX, a strategy currently being evaluated prospectively in the OPTIMOX study.

F. Maindrault-Goebel1, C. Tournigand1, T. André2, E. Carola3, M. Mabro1, P. Artru1, C. Louvet1 and A. de Gramont1,* On behalf of the French Oncology Research Group (GERCOR)

1 Service de Médecine Interne-Oncologie, Hôpital Saint-Antoine, Paris; 2 Service d'Oncologie Médicale, Hôpital Tenon, Paris; 3 Hôpital de Senlis, Service de Médecine 2, Senlis, France

* Correspondence to: Professor A. de Gramont, Hôpital Saint-Antoine, 184 rue du Faubourg Saint-Antoine, 75571 Paris Cedex 12, France. Tel: +33-1-49-28-23-36; Fax: +33-1-49-28-23-44; Email: aimery.de-gramont{at}sat.ap-hop-paris.fr

Key words: 5-fluorouracil, leucovorin, metastatic colorectal cancer, neurotoxicity, oxaliplatin


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