© 2006 European Society for Medical Oncology
symposium article |
FOLFIRI with or without celecoxib in advanced colorectal cancer: a randomized phase II study of the Gruppo Oncologico dell'Italia Meridionale (GOIM)
1 Oncology Institute, Bari; 2 Casa Sollievo della Sofferenza Hospital, S. Giovanni Rotondo; 3 University of Palermo; 4 Oncologic Center, Rionero in Vulture; 5 Ospedale Nord, Taranto, 6 Cardarelli Hospital, Campobasso, 7 Regina Elena Institute, Rome, Italy
* Correspondence to: Dr E. Maiello, Medical Oncology Unit, Casa Sollievo della Sofferenza Hospital, Viale dei Cappuccini, 71013 San Giovanni Rotondo, Italy. Tel: +39-0882-410640; Fax: +39-0882-412792; E-mail: e.maiello{at}operapadrepio.it
Background: The aim of the study was to verify the efficacy and safety of the addition of celecoxib to FOLFIRI combination therapy in patients affected by advanced colorectal cancer.
Patients and methods: Eighty-one chemotherapy-naïve patients entered in this randomized phase II trial of the GOIM (protocol no. 2301). Patients were randomized to receive FOLFIRI regimen (arm A): irinotecan 180 mg/m2 on day 1 with LV5FU2 regimen (LV at 100 mg/m2 administered as a 2-h infusion before FU at 400 mg/m2 as an intravenous bolus injection, and FU at 600 mg/m2 as a 22-h infusion immediately after 5-FU bolus injection on day 1 and 2); or FOLFIRI plus celecoxib 400 mg twice daily for 14 days (arm B). Both treatments were repeated every 2 weeks.
Results: Seventy-seven patients (38 in arm A and 39 in arm B) were evaluable for response. The overall response rate was 41% in arm A (95% CI 27% to 57%) and 35% in arm B (95% CI 20% to 50%). When only assessable patients were analyzed, overall response rate was 45% in arm A (95% CI 29% to 61%) and 36% in arm B (95% CI 21% to 51%). Median time to progression, median duration of response and survival were, respectively, 8 months, 9 months and 16 months in arm A, and 7 months, 9 months and 19 months in arm B. All patients were evaluable for toxicity, which was globally mild in both arms; grade 34 toxicity was uncommon, and gastrointestinal disturbances were the most common.
Conclusions: FOLFIRI regimen is effective and well-tolerated as a first-line treatment in patients with advanced colorectal cancer. The addition of celecoxib to FOLFIRI regimen does not improve results.
Key words: colorectal cancer, folinic acid, fluorouracil, irinotecan, celecoxib
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