FOLFOXIRI for First-Line Treatment of Unresectable Colorectal Cancer with Liver Metastases in a Resource-Limited Setting

Vuong Dinh Thy Hao ¹, Phan Minh Tri ^2,3, Doan Tien My ³

⁰Chemotherapy Department, Cancer Center, Cho Ray Hospital, Ho Chi Minh City, Vietnam.

Journal of Gastrointestinal Cancer +

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October 31, 2024

View abstract on PubMed

Summary

FOLFOXIRI chemotherapy shows promising results for colorectal cancer liver metastases in Vietnam. This treatment improved response rates and survival, demonstrating its effectiveness in a low-to-middle-income country setting.

Area Of Science

Oncology
Gastroenterology
Clinical Trials

Background

Limited data exists on FOLFOXIRI chemotherapy for unresectable colorectal cancer (CRC) liver metastases in low-to-middle-income countries (LMICs).
This study evaluates FOLFOXIRI in a Vietnamese LMIC setting.

Purpose Of The Study

To assess the safety and effectiveness of FOLFOXIRI in patients with unresectable colorectal cancer liver metastases in Vietnam.
To address the gap in knowledge regarding FOLFOXIRI's use in LMIC settings.

Main Methods

A prospective study enrolled 92 patients with unresectable CRC liver metastases.
Patients received FOLFOXIRI every 2 weeks with G-CSF prophylaxis.
Outcomes included R0/R1 resection rate, progression-free survival (PFS), overall survival (OS), objective response rate (ORR), disease control rate (DCR), and adverse events (AEs).

Main Results

The objective response rate (ORR) was 85.1% and the disease control rate (DCR) was 95.4%.
62% of patients achieved resectability, with an 88.9% R0/R1 resection rate.
Median PFS was 13 months and median OS was 22 months; 34.8% experienced severe adverse events.

Conclusions

FOLFOXIRI significantly improves response rates, resection rates, and survival in colorectal cancer liver metastases.
Further research is needed to optimize FOLFOXIRI's efficacy and minimize toxicity in LMIC populations.

Keywords:

Colorectal cancer Liver metastasis Neoadjuvant chemotherapy Response Survival