XELIRI compared with FOLFIRI as a second‑line treatment in patients with metastatic colorectal cancer

Cui,Chengxu; Shu,Chang; Yang,Yi; Liu,Junbao; Shi,Shuping; Shao,Zhujun; Wang,Nan; Yang,Ting; Hu,Songnian

doi:10.3892/ol.2014.2335

XELIRI compared with FOLFIRI as a second‑line treatment in patients with metastatic colorectal cancer

Authors:
- Chengxu Cui
- Chang Shu
- Yi Yang
- Junbao Liu
- Shuping Shi
- Zhujun Shao
- Nan Wang
- Ting Yang
- Songnian Hu
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Affiliations: Department of Oncology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Beijing 100021, P.R. China, CAS Key Laboratory of Genome Sciences and Information, Beijing Institute of Genomics, Chinese Academy of Sciences, Beijing 100101, P.R. China, Department of Oncology, Beijing Chaoyang San Huan Cancer Hospital, Beijing 100122, P.R. China
Published online on: July 10, 2014 https://doi.org/10.3892/ol.2014.2335
Pages: 1864-1872

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Abstract

The aim of this study was to compare the efficacy, safety and survival rate of a treatment regimen comprising capecitabine plus irinotecan (XELIRI) to those of a standard regimen comprising leucovorin, fluorouracil and irinotecan (FOLFIRI), to determine the correlation among the inherited genetic variations in UGT1A1, UGT1A7 and UGT1A9. A total of 84 consecutive patients with histologically confirmed metastatic colorectal cancer (mCRC) were included in the study. All patients were treated with FOLFIRI or XELIRI. The median progression‑free survival time was 4.4 months for FOLFIRI and 5.7 months for XELIRI (hazard ratio=1.35; 95% confidence interval, 0.83‑2.21; P=0.22). When compared with FOLFIRI (6.34%), XELIRI was associated with lower rates of severe toxicity (3.29) (P=0.026) and similar disease control rates (69.57% for FOLFIRI and 61.11% for XELIRI; P=0.49). In total, 17 single nucleotide polymorphisms were identified, five of which revealed an association with grade 3/4 neutropenia, including UGT1A7*4; however, UGT1A1*28 and UGT1A1*6, which have been previously reported, were not significant. Additionally, H2 haplotypes, which include UGT1A9*22, and H5 and H7 haplotypes, which include UGT1A7*2, UGT1A7*3 and UGT1A7*4, were associated with a higher risk of severe neutropenia. In conclusion, XELIRI is an effective treatment regimen with acceptable response rates and tolerability for mCRC patients as a second‑line treatment. Furthermore, inherited genetic variations in UGT1A1, UGT1A7 and UGT1A9 are associated with grade 3/4 neutropenia.

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