Abstract. The aim of this study was to evaluate the efficacy and safety of co-administration of oral S-1 and oxaliplatin (SOX) in combination with bevacizumab (bev) in patients with advanced recurrent colorectal cancer. A retrospective study of 36 patients with advanced recurrent colorectal cancer was performed, of whom 27 received first-line and 9 received second-line SOX+bev chemotherapy between 2010 and 2013 at the Hachioji Digestive Disease Hospital (Hachioji, Japan). The SOX+bev regimen consisted of administration of intravenous oxaliplatin (85 mg/m 2 ) on days 1 and 14, bevacizumab (5 mg/kg) on day 1, and co-administration of oral S-1 twice daily on days 1-14. The drug regimen was repeated every 4 weeks. SOX+bev treatment was associated with a response rate of 45.2%, a disease control rate of 71%, and a median progression-free survival (PFS) and overall survival (OS) of 9.9 and 21.9 months, respectively. Patients who received first-line chemotherapy benefited from treatment in terms of prolonged PFS (13.8 months) and OS (28.2 months). Grade 3/4 adverse events were infrequent and included anaemia, thrombocytopenia, anorexia, diarrhea, sensory neuropathy, increased aspartate aminotransferase level and skin rash. In conclusion, SOX+bev therapy was found to be feasible and safe for patients with advanced and recurrent colorectal cancer.
IntroductionThe combination of leucovorin, 5-fluorouracil (5-FU), and oxaliplatin (FOLFOX) and bevacizumab (bev) has been extensively used as first-line treatment for metastatic colorectal cancer (1,2). However, infusion or injection of 5-FU with leucovorin has certain disadvantages, including increased cost, inconvenience and morbidity associated with the use of a portable infusion pump and central venous catheter (3). The use of oral anticancer drugs has helped to overcome problems associated with continuous infusion, infection and thrombosis. S-1 is an oral anticancer drug that combines the prodrug tegafur with two modulators of 5-FU metabolism, gimeracil and oteracil (4). Several phase III clinical trials on metastatic colorectal cancer have demonstrated that oral S-1 may substitute infusional 5-FU (5,6). Furthermore, a phase III trial of first-line treatments in patients with metastatic colorectal cancer (SOFT trial) demonstrated that the combination of S-1 and oxaliplatin with bevacizumab (SOX+bev) was as efficacious as FOLFOX6+bev with respect to progression-free survival (PFS) (7). Therefore, the aim of the present study was to evaluate the efficacy and safety of SOX+bev for patients with advanced recurrent colorectal cancer.
Patients and methods
Patients.A total of 36 patients with advanced recurrent colorectal cancer who were administered SOX+bev chemotherapy between January, 2010 and December, 2013 at the Department of Surgery, Hachioji Digestive Disease Hospital (Tokyo, Japan) were included in this retrospective study. All patients provided written informed consent prior to treatment initiation. All the patients had sufficient oral drug intake. The patient inclusion...