Abstract：
BACKGROUND:With improved survival and longer duration of treatment, clinicians managing metastatic colorectal cancer (mCRC) increasingly consider intermittent (IC) or maintenance chemotherapy (MC), but the effect of these treatment modifications on real-world outcomes is unclear. PATIENTS AND METHODS:Using a population-based cohort of mCRC patients who received combination chemotherapy, we aimed to describe the use of IC/MC and their effect on overall survival (OS). RESULTS:Among 617 patients, 120 (19%) had periods of IC, 67 (11%) had periods of MC, and 53 (9%) had periods of both. Most (85.5%) modifications occurred in the first-line setting. The receipt of IC (median OS [mOS], 37 vs. 21 months; P < .0001) or MC (mOS, 36 vs. 24 months; P = .0015) was associated with improved mOS compared with continuous combination therapy. In multivariate analysis adjusting for age, sex, and regimen used at the time of treatment modification, IC (hazard ratio [HR], 0.52; 95% confidence interval [CI], 0.42-0.65; P < .0001), MC (HR, 0.71; 95% CI, 0.58-0.88; P = .002), and the combination (HR, 0.45; 95% CI, 0.33-0.63; P < .0001) were all associated with improved mOS. Among patients receiving MC, individuals with (HR, 0.69; 95% CI, 0.53-0.90; P = .005) and without (HR, 0.74; 95% CI, 0.55-1.00; P = .048) re-escalation to their original cytotoxic regimen had improved mOS compared with continuous therapy. The use of IC was associated with an improved OS compared with MC (HR, 0.65; 95% CI, 0.47-0.90; P = .009). CONCLUSION:In patients with mCRC, IC and MC are reasonable options to maintain quality of life and do not appear to negatively affect OS in carefully selected patients.
journal_name
Clin Colorectal Cancerjournal_title
Clinical colorectal cancerauthors
Loree JM,Tan SK,Lafond LM,Speers CH,Kennecke HF,Cheung WYdoi
10.1016/j.clcc.2017.10.011subject
Has Abstractpub_date
2018-03-01 00:00:00pages
65-72issue
1eissn
1533-0028issn
1938-0674pii
S1533-0028(17)30197-4journal_volume
17pub_type
杂志文章abstract：:Modern chemotherapy combinations for metastatic colorectal cancer (mCRC) comprise infusional 5-fluorouracil (5-FU), leucovorin, and irinotecan or oxaliplatin. The fluoropyrimidine derivative capecitabine is at least as effective as 5-FU plus leucovorin bolus regimens. It displays a favorable toxicity profile and offer...
journal_title：Clinical colorectal cancer
pub_type： 杂志文章,评审
doi：10.3816/CCC.2008.n.015
更新日期：2008-03-01 00:00:00
abstract：BACKGROUND:The novel severe acute respiratory syndrome coronavirus 2 virus that emerged in December 2019 causing coronavirus disease 2019 (COVID-19) has led to the sudden national reorganization of health care systems and changes in the delivery of health care globally. The purpose of our study was to use a survey to a...
journal_title：Clinical colorectal cancer
pub_type： 杂志文章
doi：10.1016/j.clcc.2020.05.011
更新日期：2020-09-01 00:00:00
abstract：BACKGROUND:Similar epidemiologic characteristics suggest a common etiology for colon cancer (CC) and diverticular disease of the colon (DD). The relationship between the 2 diseases is still unclear, and the impact of DD in patients diagnosed with CC on disease-free survival (DFS) and overall survival (OS) is unknown. N...
journal_title：Clinical colorectal cancer
pub_type： 临床试验,杂志文章
doi：10.3816/ccc.2006.n.031
更新日期：2006-07-01 00:00:00
abstract：BACKGROUND:The optimal therapeutic strategy for metastatic colorectal cancer patients is still a matter of debate. There are no prognostic variables indicating how many lines individual patients ought to receive, and whether later lines could be effective even when earlier ones were not. PATIENTS AND METHODS:We retros...
journal_title：Clinical colorectal cancer
pub_type： 杂志文章
doi：10.1016/j.clcc.2017.03.019
更新日期：2017-12-01 00:00:00
abstract：BACKGROUND:Metastatic colorectal cancer (CRC) outcomes continue to improve, but they vary significantly by race and ethnicity. We hypothesize that these disparities arise from unequal access to care. MATERIALS AND METHODS:The Harris Health System (HHS) is an integrated health delivery network that provides medical car...
journal_title：Clinical colorectal cancer
pub_type： 杂志文章
doi：10.1016/j.clcc.2019.09.002
更新日期：2020-06-01 00:00:00
abstract：:Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal cancer of teh gastrointestinal tract. They are characterized by the expression of KIT. Therapeutically, metastatic GISTs are effectively treated by imatinib, a tyrosine kinase inhibitor (TKI) with activity against KIT and platelet-derived growth f...
journal_title：Clinical colorectal cancer
pub_type： 杂志文章,评审
doi：10.3816/ccc.2006.s.005
更新日期：2006-11-01 00:00:00
abstract：:The standard in rectal cancer has been to add adjuvant radiation therapy to surgery in patients with stage II and III disease. Total mesorectal excision has led to lower local recurrence rates, and, if properly performed, may make adjuvant radiation unnecessary for certain stage II and III patients, such as T3 N0 pati...
journal_title：Clinical colorectal cancer
pub_type： 杂志文章,评审
doi：10.3816/CCC.2003.n.002
更新日期：2003-02-01 00:00:00
abstract：:Thymidylate synthase (TS) is a key enzyme in the synthesis of 2'-deoxythymidine-5'-monophosphate, an essential precursor for DNA biosynthesis. For this reason, this enzyme is a critical target in cancer chemotherapy. As the first TS inhibitor in clinical use, 5-fluorouracil (5-FU) remains widely used for the treatment...
journal_title：Clinical colorectal cancer
pub_type： 杂志文章,评审
doi：10.3816/CCC.2002.n.003
更新日期：2002-02-01 00:00:00
abstract：:This phase II study was designed to characterize the clinical activity of ISIS 3521 in patients with metastatic colorectal cancer (CRC). Sixteen patients with pretreated or refractory CRC were treated with ISIS 3521. Eleven patients were given a dose of 2.0 mg/kg per day, and 5 patients received 3.0 mg/kg per day give...
journal_title：Clinical colorectal cancer
pub_type： 临床试验,杂志文章
doi：10.3816/ccc.2004.n.026
更新日期：2004-11-01 00:00:00
abstract：:Colorectal cancer (CRC), one of the most common malignancies worldwide, is often diagnosed at an advanced stage, and resistance to chemotherapeutic and existing targeted therapy is a major obstacle to its successful treatment. New targets that offer alternative clinical options are therefore urgently needed. Recently,...
journal_title：Clinical colorectal cancer
pub_type： 杂志文章,评审
doi：10.1016/j.clcc.2016.06.006
更新日期：2017-03-01 00:00:00
abstract：BACKGROUND:5-Fluorouracil (5-FU) chemotherapy is associated with severe and unpredictable toxicity in a significant proportion of patients. 5,10-Methylenetetrahydrofolate and 5-fluorodeoxyuridine monophosphate bind to thymidylate synthase and together inhibit its function, resulting in cytotoxicity. We hypothesized tha...
journal_title：Clinical colorectal cancer
pub_type： 杂志文章
doi：10.1016/j.clcc.2016.06.001
更新日期：2016-12-01 00:00:00
abstract：BACKGROUND:Gemcitabine-related pneumonitis (GRP) has been reported relatively frequently for pancreas cancer in the literature; however, underlying risk factors and optimal management remain to be defined. We studied a cohort of patients with GRP and investigated potential predisposing factors in pancreatic cancer pati...
journal_title：Clinical colorectal cancer
pub_type： 杂志文章
doi：10.1016/j.clcc.2015.08.003
更新日期：2016-03-01 00:00:00
abstract：PURPOSE:American Society of Clinical Oncology (ASCO) guidelines define high-risk prognostic features (HRFs) in stage II colon cancer and recommend limiting adjuvant chemotherapy to patients with HRFs. We evaluated the extent to which HRFs influenced decisions on adjuvant chemotherapy before and after publication of the...
journal_title：Clinical colorectal cancer
pub_type： 杂志文章
doi：
更新日期：2009-04-01 00:00:00
abstract：BACKGROUND:The safety of bevacizumab in older mCRC patients is poorly understood. The purpose of this analysis was to determine the prevalence, incidence, and risk factors for treatment-related AEs in older bevacizumab recipients. PATIENTS AND METHODS:Patients age ≥65 were identified from SEER-Medicare and categorized...
journal_title：Clinical colorectal cancer
pub_type： 杂志文章
doi：10.1016/j.clcc.2012.11.004
更新日期：2013-09-01 00:00:00
abstract：:Bevacizumab is a humanized monoclonal antibody approved by the US Food and Drug Administration for use in combination with fluorouracil (FU)-based chemotherapy for first-line treatment of patients with metastatic colorectal carcinoma (CRC). Its mechanism of action is inhibition of tumor angiogenesis by neutralizing va...
journal_title：Clinical colorectal cancer
pub_type： 杂志文章
doi：10.3816/CCC.2010.n.008
更新日期：2010-01-01 00:00:00
abstract：BACKGROUND:Metastatic colorectal cancer (mCRC) is increasingly treated using targeted therapies. Their real-life evaluation is insufficient, especially in elderly and frail patients. The aim was to describe use, safety, and effectiveness of targeted therapies in first-line mCRC treatment according to age. PATIENTS AND...
journal_title：Clinical colorectal cancer
pub_type： 杂志文章
doi：10.1016/j.clcc.2018.11.005
更新日期：2019-03-01 00:00:00
abstract：:As new improvements in the treatment of colorectal cancer have become available, it has become important to understand the benefits of new therapies or the deleterious effects stemming from the increased risk of toxicity. In particular, a more rational approach to adjuvant chemotherapy for patients with stage II/III d...
journal_title：Clinical colorectal cancer
pub_type： 杂志文章,评审
doi：10.3816/ccc.2006.n.019
更新日期：2006-05-01 00:00:00
abstract：UNLABELLED:Two identical randomized controlled trials designed to optimize adjuvant treatment of colon cancer (CC) (n =855) and rectal cancer (RC) (n = 796) were performed. Long-term evaluation confirmed that the addition of folinic acid (FA) to 5-fluorouracil (5-FU) improved 7-year overall survival (OS) in CC but not ...
journal_title：Clinical colorectal cancer
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.clcc.2012.07.005
更新日期：2013-03-01 00:00:00
abstract：:Regimens based on flouropyrimidines (eg, 5-fluorouracil [5-FU] and capecitabine) are the mainstay of chemotherapy for several malignancies, including colon, pancreatic, upper gastrointestinal, and breast cancers. Warfarin is one of the most commonly used oral anticoagulants. Patients receiving concomitant capecitabine...
journal_title：Clinical colorectal cancer
pub_type： 杂志文章,评审
doi：10.3816/ccc.2005.n.028
更新日期：2005-09-01 00:00:00
abstract：:In the past 10 years, overall survival and disease-free survival of patients with colorectal cancer (CRC) has improved substantially because of a combination of factors: (1) more accurate staging as a result of advances in imaging technology; (2) refinements in surgical technique; (3) 'curative' metastasectomy for pat...
journal_title：Clinical colorectal cancer
pub_type： 杂志文章
doi：10.3816/CCC.2009.n.013
更新日期：2009-03-01 00:00:00
abstract：BACKGROUND:Initial treatment with either neoadjuvant chemoradiation (CRT) or induction FOLFOX (5-Fluorouracil, leucovorin, and oxaliplatin) chemotherapy followed by CRT is considered standard treatment for locally advanced rectal cancer. We compared patient-reported outcomes (PRO) during CRT in patients who had receive...
journal_title：Clinical colorectal cancer
pub_type： 杂志文章
doi：10.1016/j.clcc.2019.04.001
更新日期：2019-09-01 00:00:00
abstract：BACKGROUND:The Irinotecan Cetuximab Evaluation and Cetuximab Response Evaluation (ICECREAM) study assessed the efficacy of cetuximab monotherapy compared with cetuximab combined with chemotherapy for quadruple wild-type (KRAS, NRAS, BRAF, or P13KCA exon 20) metastatic colorectal cancer. PATIENTS AND METHODS:Patients w...
journal_title：Clinical colorectal cancer
pub_type： 杂志文章,多中心研究,随机对照试验
doi：10.1016/j.clcc.2018.06.002
更新日期：2018-12-01 00:00:00
abstract：INTRODUCTION:Bevacizumab improves outcome for patients with advanced colorectal cancer (CRC) when added to chemotherapy. The HORIZON I trial resulted in similar outcome with bevacizumab or cediranib, a small-molecule tyrosine kinase inhibitor of vascular endothelial growth factor (VEGF) receptor, as treatment of advanc...
journal_title：Clinical colorectal cancer
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.clcc.2013.11.002
更新日期：2014-03-01 00:00:00
abstract：PURPOSE:The tumor-activated fluoropyrimidine capecitabine achieves response rates superior to those of bolus 5-fluorouracil/leucovorin (5-FU/LV) as first-line treatment for metastatic colorectal cancer (CRC), with favorable safety and fewer hospitalizations. Capecitabine is also at least as effective as bolus 5-FU/LV i...
journal_title：Clinical colorectal cancer
pub_type： 杂志文章
doi：10.3816/ccc.2005.n.021
更新日期：2005-07-01 00:00:00
abstract：:Local excision is an alternative approach to radical proctectomy for rectal cancer, but from an oncologic standpoint, it is a compromise, and its role remains controversial. Careful patient selection is essential because local excision is generally considered only for early rectal cancer with no evidence of nodal meta...
journal_title：Clinical colorectal cancer
pub_type： 杂志文章,评审
doi：10.3816/CCC.2008.n.050
更新日期：2008-11-01 00:00:00
abstract：:This article reviews the current status of the topoisomerase I (top I) inhibitors in the treatment of gastrointestinal (GI) malignancies. We focus on oral drug administration, the mode of administration that is generally preferred by patients with cancer. However, the great majority of the studies have been performed ...
journal_title：Clinical colorectal cancer
pub_type： 杂志文章,评审
doi：10.3816/ccc.2004.n.017
更新日期：2004-09-01 00:00:00
abstract：:Primary squamous cell colorectal carcinomas are uncommon, and their characteristics are not well known. They seem to occur most commonly in the fifth decade of life with a slight predominance for men. The most commonly reported anatomic locations are the rectum and the proximal colon. Clinical features and common diag...
journal_title：Clinical colorectal cancer
pub_type： 杂志文章
doi：10.3816/CCC.2001.n.006
更新日期：2001-05-01 00:00:00
abstract：UNLABELLED:Patients with colorectal cancer (CRC) and renal cell carcinoma (RCC) may be at risk for additional primary malignancies. A review of 101 patients with these concurrent diagnoses was performed. Forty-two percent of patients had 1 or more additional malignancies; none appeared to be associated with Lynch syndr...
journal_title：Clinical colorectal cancer
pub_type： 临床试验,杂志文章
doi：10.1016/j.clcc.2012.07.004
更新日期：2013-03-01 00:00:00
abstract：BACKGROUND:In this study, the maximum tolerated dose and toxicity profile of FOLFIRI (infusional fluorouracil [5-FU]/leucovorin/irinotecan) plus gefitinib (an oral inhibitor of the epidermal growth factor receptor) were evaluated as first-line therapy in patients with metastatic colorectal cancer. PATIENTS AND METHODS...
journal_title：Clinical colorectal cancer
pub_type： 杂志文章
doi：10.3816/CCC.2006.n.037
更新日期：2006-09-01 00:00:00
abstract：BACKGROUND:Systemic chemotherapy increases the possibility of resection in patients with initially unresectable colorectal cancer (CRC), especially patients with hepatic metastasis. However, the predictive factors and prognosis of conversion to resection after chemotherapy in patients with various organ metastases rema...
journal_title：Clinical colorectal cancer
pub_type： 杂志文章
doi：10.1016/j.clcc.2017.10.002
更新日期：2018-03-01 00:00:00
