Efficacy And Safety Of Irinotecan,Oxaliplatin And Capecitabine(XELOXIRI)in Patients With Colorectal Cancer

Background FOLFOXIRI(irinotecan,oxaliplatin,5-fluorouracil)and FOLFOXIRI plus targeted therapy have been listed as suitable options in first-line treatment for metastatic colorectal cancer(mCRC)by international guidelines,and also explored as neoadjuvant treatment for local advanced colorectal cancer(LACRC).Capecitabine,a widely used oral fluoropyrimidine pro-drug that achieves tumor-selective generation of 5FU,demonstrate a superior safety profile and response rate in first-line therapy of mCRC and consequently provide an interesting alternative to 5FU.However,the relevant studies of evaluating safety and efficacy of capecitabine plus oxaliplatin and irinotecan are lacking.We conducted a retrospective study to evaluate XELOXIRI or XELOXIRI plus target therapy for CRC patients in terms of safety and efficacy in clinal practice of our hospital and hope to provide reference for further investigations.Methods Between January 2017 and November 2019,72 patients with histologically or cytologically confirmed advanced CRC and administered XELOXIRI or XELOXIRI plus target therapy were retrospectively analyzed.The XELOXIRI regimen consisted of oxaliplatin 70-100 mg/m2(2-hour Ⅳ infusion),irinotecan 120-170 mg/m2(90 min Ⅳinfusion)on day 1 and oral capecitabine 600-1000 mg/m2 twice a day on days 1-7 were administered every two weeks.Among 29 patients treated with combination of a target drug,Bevacizumab 5mg/kg or cetuximab 500mg/m2 was administered every two weeks.Efficacy were evaluated according to the objective response rate(ORR),the disease control rate(DCR),the DFS of patients obtained R0 resection,the progress-free survival(PFS)and the overall survival of patients with unresectable metastasis and safety according to adverse events.Results Of 72 patients,10 patients have LACRC and 62 have mCRC.As of the data cutoff of May 28,2020,most of patients received maintenance therapy or subsequent treatment.The median duration treatment was 6 cycles.Of 49 patients with measurable lesion according to RECIST version 1.1,the best ORR was 69.4%and the DCR was 87.8%.All the 10 LACRC patients received R0 resection and the median DFS and median OS of these patients haven’t yet reached.In 62 mCRC,14 in 22 patients who undergone excision obtained the no evidence of disease(NED),the R0 conversion resection rate was 22.6%.3 more patients are waiting for excision.For 14NED patients,the median DFS was 5.7 months,the 1-year DFS rate was 23.1%,the median PFS was 9.1 months,the 1-year PFS rate was 30.9%-while the median OS haven’t obtained.The frequency of any grade of adverse events was 94.4%(68/72).The grade≥3 adverse events were leukocytopenia(12.5%]),neutropenia(20.8%]),febrile neutropenia(4.2%),thrombocytopenia 1.4%]),diarrhea 2.8%])and vomiting 2.8%]).Conclusion XELOXIRI or combined with targeted drug regimens with a manageable toxicity profile are feasible and results in promising efficacy among Chinese patients with advanced colorectal cancer.