FOLFIRI Chemotherapy for Metastatic Colorectal Cancer Patients
Pimkhuan Kamnerdsupaphon MD*, Vicharn Lorvidhaya MD*, Imjai Chitapanarux MD*, Anun Tonusin MD*, Vimol Sukthomya MD*
Affiliation : * Division of Therapeutic Radiology and Oncology, Faculty of Medicine, Chiang Mai University, Chiang Mai
Objectives : 1) To confirm the efficacy of irinotecan plus folinic acid/continuous 5-fluorouracil as bimonthly
FOLFIRI regimen in metastatic colorectal cancer patients. Efficacy evaluations will include response rate,
duration of response, and survival. 2) To evaluate safety profiles on patients receiving this combination.
Materials and Methods : Nineteen patients with metastatic colorectal cancer received 180mg/m2 intravenous
(iv) day 1 of irinotecan, 200 mg/m2 iv of folinic acid, 400 mg/m2 iv bolus days 1 to 2, 5-fluorouracil (5-FU), and
600 mg/m2 iv 5-FU infusion over 22 hours, days 1 to 2. Treatment was repeated every two weeks and one cycle
contained three fortnightly administrations. Sites of disease were liver in nine patients, lungs in three patients,
bowels in four patients, lymph nodes in three patients, and peritoneum in two patients. Two patients had >1
metastatic site. Previous treatments included adjuvant chemotherapy in seven cases and front-line chemo-
therapy for advanced disease in one case.
Results : A median of six treatment cycles was completed (range, 2-13 cycles). All patients were assessable for
toxicity and 16 patients were evaluable for treatment response. The non-hematological toxicity was mild.
Most had grade 1 or 2. Only one patient experienced grade 3 fatigue and anorexia, and discontinued chemo-
therapy after the second cycle. There were no cases with grade 4 toxicity. Fourteen patients had at least grade
2 alopecia. The most common hematological toxicity was neutropenia. Grade 3 and 4 neutropenia were
observed in three and two patients, respectively. There was no case of febrile neutropenia. Based on intention
to treat analysis, there were no complete responses (CR), five (26.3%) partial response (PR), and 11 (57.9%)
stable disease. With the median follow-up of 6.6 months, the median time to disease progression was 4.7
months and the median survival time was 10.6 months.
Conclusion : Bimonthly irinotecan in combination with folinic acid and 5-fluorouracil was active with ac-
ceptable toxicities and a prolonged survival time in pretreated colorectal cancer. Additional trials to define
the optimal dose and schedule of treatment are justified.
Keywords : Metastatic colorectal cancer, Irinotecan
