PLoS ONE (Jan 2021)

Tumor growth rate during re-challenge chemotherapy with previously used agents as salvage treatment for metastatic colorectal cancer: A retrospective study.

  • Masashi Ishikawa,
  • Atsuo Takashima,
  • Yusuke Nagata,
  • Ryoichi Sawada,
  • Masahiko Aoki,
  • Hiroshi Imazeki,
  • Hidekazu Hirano,
  • Hirokazu Shoji,
  • Yoshitaka Honma,
  • Satoru Iwasa,
  • Natsuko Okita,
  • Ken Kato,
  • Masayuki Saruta,
  • Narikazu Boku

DOI
https://doi.org/10.1371/journal.pone.0257551
Journal volume & issue
Vol. 16, no. 9
p. e0257551

Abstract

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BackgroundIn clinical practice, the same chemotherapeutic agents are occasionally reused (re-challenge) after failure of all available standard chemotherapy options for metastatic colorectal cancer (mCRC). However, the benefits of re-challenge chemotherapy (Re-Cx) are unclear. This retrospective study evaluated the efficacy of Re-Cx, focusing on the tumor growth rate (TGR).MethodsThe study included mCRC patients with measurable lesions who received Re-Cx from November 2011 to October 2018 at National Cancer Center Hospital. Re-Cx was defined as re-administration of agents which had been used in prior lines of chemotherapy and discontinued due to disease progression. We compared the TGR immediately after initiating Re-Cx regimens with that observed at the time of disease progression during prior chemotherapy (Prior-Cx) immediately before Re-Cx.ResultsOf the 25 patients who received Re-Cx, five patients received two Re-Cx regimens. Therefore, a total of 30 cases of Re-Cx were analyzed in this study. The regimens of Re-Cx were oxaliplatin based (19 cases), irinotecan based (8 cases), and others (3 cases). Although the objective response rate to Re-Cx was 0%, the disease control rate was 60% (18 cases), and 40% (12 cases) showed some tumor shrinkage. We compared the effects of Re-Cx and Prior-Cx by the TGR and found that the TGR of Re-Cx was slower than that recorded in Prior-Cx in 26 of 30 cases (87%). In particular, the ratio of% TGR ConclusionWe found that Re-Cx may have some anti-tumor efficacy as salvage treatment for mCRC and these results also suggested the clinical benefits of Re-Cx.