OBJECTIVETo observe the clinical efficacy of cetuximab plus chemotherapy in the treatment of metastatic colorectal carcinoma.

METHODSClinicopathological data of 128 patients with metastatic colorectal cancer admitted in the Department of Oncology, Chinese PLA General Hospital from 2008 to June 2012 were analyzed retrospectively. Among them, 91 patients received cetuximab as the first-line therapy and 37 in the second-line or more-line therapy. The chemotherapy regimens included oxaliplatin-based therapy (FOLFOX/XELOX), irinotecan-based therapy (FOLFIRI/XELIRI) and fluorouracil-based therapy (Xeloda). The efficacy was evaluated according to RECIST 1.0 criteria. The remission rate, control rate and time to disease progression were compared among patients receiving cetuximab combined with different chemotherapy regimens in different periods.

RESULTSThe disease control rate of cetuximab applied in the first-line treatment was higher than that of the second-line or more-line [85.9% (61/71) vs. 59.3% (16/27), P=0.004]. The disease control rate of the group treated with cetuximab plus oxaliplatin-based chemotherapy was much higher compared to the other two groups [91.1% (41/45) vs. 68.1% (32/47), 4/6, P=0.021]. But there were no significant differences among three regimens in the terms of overall response rate (all P>0.05). The median time to progression of groups with cetuximab plus irinotecan, oxaliplatin or capecitabine was 7.8 months, 8.5 months and 5.2 months respectively. The median time to progression of cetuximab combined with chemotherapy in the first-line treatment and the second-line or more-line was 8.2 and 7.7 months respectively. However, the differences were not statistically significant (P>0.05).

CONCLUSIONSCetuximab in combination with oxaliplatin-based chemotherapy is recommended as the first-line application in the treatment of metastatic colorectal carcinoma patients, because it is helpful to improve the rate of disease control.

Antineoplastic Combined Chemotherapy Protocols ; Camptothecin ; analogs & derivatives ; Cetuximab ; Colorectal Neoplasms ; Deoxycytidine ; analogs & derivatives ; Fluorouracil ; analogs & derivatives ; Humans ; Leucovorin ; Neoplasm Metastasis ; Organoplatinum Compounds ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo evaluate the efficacy and safety of autologous cytokine-induced killer (CIK) cell t combined with XELOX regimen in treatment of senile advanced gastric cancer.

METHODSForty-six cases of senile advanced gastric cancer patients with a mean age of 70 years were prospectively divided into two groups according to individual acceptance of CIK cells: 25 patients receiving autologous CIK cell treatment combined with XELOX regimen (trial group) and 21 patients receiving simple chemotherapy (control group). Patients in CIK group were matched to those in control group by sex, ages, KPS ranking scores, histological type, pathological grade, and clinical stage. Immune reaction, adverse reaction, time to progression (TTP) and overall survival (OS) were evaluated.

RESULTSHost immune function was increased (P<0.05) and the adverse reaction was decreased in patients of trial group as compared to control group. There were no significant differences in response rate (RR)(33.3% vs. 23.1%, P>0.05), disease control rate (DCR)(86.7% vs. 80.8%, P>0.05) between the two groups. TTP (4.8 months vs. 3.1 months, P<0.05) and OS (7.1 months vs. 5.9 months, P<0.05) in trial group were significantly improved as compared to control group.

CONCLUSIONAutologous CIK cells combined with XELOX regimen can increase immune function, improve clinical efficacy, decrease adverse reaction and prolong OS for senile patients with advanced gastric cancers.

Aged ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Cytokine-Induced Killer Cells ; immunology ; Deoxycytidine ; analogs & derivatives ; Fluorouracil ; analogs & derivatives ; Humans ; Immunotherapy, Adoptive ; Prospective Studies ; Stomach Neoplasms ; immunology ; therapy

OBJECTIVETo summarize the prognostic factors of stage 3 colorectal cancer.

METHODSThe clinical data of 433 patients with stage 3 colorectal cancer who were admitted to our hospital from January 2005 to December 2008 for radical surgery and adjuvant chemotherapy were retrospectively analyzed. Relationship of their clinicopathologic features and treatment with the prognosis were analyzed.

RESULTSOf these 433 stage 3 patients,the mean disease-free survival was (72.37 ± 2.11) months and mean overall survival was (79.91 ± 2.02) months; however, the median survival times were not reached. The 1-,3-, and 5-year disease-free survival rate were 86.8%,77.9%, and 57.0% and the overall survival rate were 91.5%,75.1%, and 63.3%. Multivariate COX regression analysis displayed that intestine obstruction before surgery, complications after surgery,tumor location,positive surgical margin, neural cell infiltration,vessel cancer embolus, TNM stage, lymph node ratio, adjuvant chemotherapy regimens, and chemotherapy duration were the independent factors affecting disease-free and overall survivals in patients with stage 3 colorectal cancer. The efficacies of FOLFOX and XELOX regimens were significantly correlated with patient's age, complications,tumor location,and chemotherapy duration.

CONCLUSIONSComplications,tumor location, TNM stage, and positive surgical margin are the independent prognostic factors of stage 3 colorectal cancer. FOLFOX and XELOX regimen can remarkably improve prognosis,and a longer duration of chemotherapy can achieve better survival.

Antineoplastic Combined Chemotherapy Protocols ; Chemotherapy, Adjuvant ; Colorectal Neoplasms ; Deoxycytidine ; analogs & derivatives ; Disease-Free Survival ; Fluorouracil ; analogs & derivatives ; Humans ; Lymph Nodes ; Neoplasm Staging ; Prognosis ; Retrospective Studies ; Survival Rate

OBJECTIVETo compare efficacy of different adjuvant chemotherapy regimens for stage II-III gastric cancer after D2 gastrectomy in Asian patients.

METHODSAssociated literatures were searched through electronic databases and hand-searching. Prospective randomized clinical trials (RCTs) comparing adjuvant chemotherapy after D2 gastrectomy with surgery alone were included in the study. Overall survival and disease-free survival were chosen as the endpoints. Relative hazard was analyzed by Bucher adjusted indirect comparison.

RESULTSTwo RCTs were selected, including comparison between S-1 versus surgery alone and comparison between XELOX versus surgery alone. There was no statistical difference in overall survival between the two regimens (HR=0.94, 95%CI:0.62-1.44, P=0.79). The recurrence risk of S-1 was slightly higher as compared to XELOX, but no statistical difference was found (HR=1.11, 95%CI:0.80-1.53, P=0.54).

CONCLUSIONThe adjuvant chemotherapy with S-1 is similar to XELOX for stage II-III gastric cancer after D2 gastrectomy in Asian patients.

Antineoplastic Combined Chemotherapy Protocols ; Chemotherapy, Adjuvant ; Deoxycytidine ; analogs & derivatives ; Fluorouracil ; analogs & derivatives ; Humans ; Postoperative Care ; Randomized Controlled Trials as Topic ; Stomach Neoplasms ; drug therapy ; surgery ; Treatment Outcome

OBJECTIVETo evaluate the efficacy and adverse effects of weekly irinotecan combined with capecitabine as a second-line chemotherapy for treatment of advanced gastric cancer.

METHODSTwenty-one patients with advanced gastric cancer who had failed first-line therapy received irinotecan on days 1 and 8 plus capecitabine on days 1-14 for a 21-day cycle. Each patient was treated for at least two cycles and evaluated 4 weeks later for the responses.

RESULTSOf the 21 patients, none showed complete remission (CR), 5 (23.8%) showed partial remission (PR), 6 (28.6%) showed stable disease (SD) and 10 (47.6%) showed progressive disease (PD). The overall response rate was 23.8%, and 11 patients (52.4%) benefited (CR+PR+SD) from the clinical therapy, with a mean time to tumor progression of 3.61±0.97 months. The main adverse effects of this regimen included myelosuppression, nausea, vomiting and diarrhea.

CONCLUSIONThe regimen of weekly irinotecan plus capecitabine has a definite effect for treatment of advanced gastric cancer with tolerable toxicity.

Adenocarcinoma ; drug therapy ; pathology ; Adult ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Camptothecin ; administration & dosage ; analogs & derivatives ; Capecitabine ; Deoxycytidine ; administration & dosage ; analogs & derivatives ; Female ; Fluorouracil ; administration & dosage ; analogs & derivatives ; Humans ; Male ; Middle Aged ; Stomach Neoplasms ; drug therapy ; pathology ; Treatment Outcome

OBJECTIVETo evaluate efficacy, safety, and feasibility of maintenance therapy with capecitabine after fluoropyrimidines/oxaliplatin or fluoropyrimidines/irinotecan chemotherapy in patients with incurable colorectal cancer.

METHODSSeventy-three hospitalized patients with incurable colorectal cancer who received fluoropyrimidines/oxaliplatin or fluoropyrimidines/irinotecan as the first-line chemotherapy between May 2009 and December 2012 in our department were retrospectively analyzed. When the maximum percentage tumor size reduction was achieved, 42 patients received a maintenance therapy with capecitabine at 1000 mg/m(2) in two daily doses on days 1-14, and the other 31 patients without further chemotherapy or the maintenance therapy were followed up. The treatment was repeated every 3 weeks as a cycle until disease progression or intolerable toxicity. The efficacy and safety were evaluated by Kaplan-Meier analysis and Χ(2) analysis.

RESULTSThe 42 patients receiving capecitabine maintenance therapy achieved a median progression free survival (PFS) of 11.6 months (95%CI 7.8-15.4), significantly longer than the PFS of 7.4 months (95% CI 4.9-11.8) in the 31 patients without the maintenance therapy (P<0.01). The response rate (RR) after combined chemotherapy in the two groups were similar (42.8% vs 38.7%). Χ(2) analysis indicated significant reductions in the adverse reactions (P<0.05) in both groups after therapy without significant differences between the two groups (P>0.05) except for hand-foot syndrome.

CONCLUSIONIn patients with incurable colorectal cancer, capecitabine maintenance therapy following combined chemotherapy can achieve a prolonged PFS with a good safety and tolerance and retains the possibility of further intense therapy in the event of disease progression.

Antineoplastic Combined Chemotherapy Protocols ; Camptothecin ; analogs & derivatives ; Capecitabine ; Colorectal Neoplasms ; drug therapy ; Deoxycytidine ; analogs & derivatives ; Disease Progression ; Disease-Free Survival ; Fluorouracil ; analogs & derivatives ; Humans ; Kaplan-Meier Estimate ; Organoplatinum Compounds ; Retrospective Studies

Preoperative concurrent chemoradiotherapy based on 5-fluorouracil (5-FU) is an standard treatment mode for patients with locally advanced rectal cancer (LARC). Currently, more and more interests has now focused on new chemotherapeutic drugs, such as capecitabine, oxaliplatin, irinotecan, bevacizumab, and cetuximab in this treatment mode. Many prospective phase I-III clinical trials have been developed to explore these new drugs efficacy in the neoadjuvant chemoradiation (nCRT) for patients with LARC. Some results are very encouraging, yet others are undesirable. Capecitabine has been widely recognized in the nCRT for patients with LARC, and has the tendency to replace 5-FU. However, there are some controversies for oxaliplatin, irinotecan, and biologically targeted drugs in the nCRT mode because of their limited clinical benefits. It is potentially the development direction to study the mutual interaction mechanism among concurrent drugs or radiation and biologically targeted drugs, find new predicatively responsive targets, and screen the appropriate patient in the treatment of neoCRT for patients with LARC in the future.
Antineoplastic Agents ; therapeutic use ; Camptothecin ; analogs & derivatives ; therapeutic use ; Capecitabine ; Chemotherapy, Adjuvant ; Deoxycytidine ; analogs & derivatives ; therapeutic use ; Fluorouracil ; analogs & derivatives ; therapeutic use ; Humans ; Organoplatinum Compounds ; therapeutic use ; Rectal Neoplasms ; drug therapy ; surgery

No abstract available.
Antineoplastic Combined Chemotherapy Protocols/*therapeutic use ; Camptothecin/*analogs & derivatives/therapeutic use ; Female ; Fluorouracil/therapeutic use ; Humans ; Leucovorin/therapeutic use ; Male ; Organoplatinum Compounds/therapeutic use ; Stomach Neoplasms/*drug therapy

The anticancer agent's FT-207, N1-(2'-tetrahydrofuryl)-5-fluorouracil, a derivative of 5FU (5-fluorouracil), induced chromosome damage to the human leukocyte was investigated. FT-207 inhibit mitosis and cause chromatid and chromosome breakage and chromatid exchange with 20 ug/ml for 48 to 72 hours of treatment. However, with 15 ug/ml for 72 hours only delayed spiralization was produced in some of the chromosomes in the same cells. The random distribution of chromosome breakage were observed and the effect of FT-207 on the chromosomes of human leukocytes were time dependent rather than concentration dependent. The comparision of the effect of mitomycin C on human leukocytes and the action of FT-207 at specific times during the cell cycle were discussed.
Cells, Cultured ; Chromosome Aberrations* ; Female ; Fluorouracil/analogs & derivatives* ; Human ; Leukocytes/drug effects ; Leukocytes/ultrastructure* ; Male ; Mitotic Index/drug effects ; Tegafur/pharmacology* ; Time Factors

The aim of this work was to investigate guar gum/ethylcellulose mix coated pellets for potential colon-specific drug delivery. The coated pellets, containing 5-fluorouracil as a model drug, were prepared in a fluidized bed coater by spraying the aqueous/ethanol dispersion mixture of guar gum and ethylcellulose. The lag time of drug release and release rate were adjustable by changing the ratio of guar gum to ethylcellulose and coat weight gain. In order to find the optimal coating formulation that was able to achieve drug targeting to the colon, the effect of two independent variables (the ratio of guar gum to ethylcellulose and the coat weight gain) on drug release characteristics was studied using 3 x 4 factorial design and response surface methodology. Results indicated that drug release rate decreased as the proportion of ethylcellulose in the hybrid coat and the coat weight gain increased. When the ratio of guar gum to ethylcellulose was kept in the range of 0.2 to 0.7, and the coat weight gain in the range of 250% to 500%, the coated pellets can keep intact for about 5 h in upper gastrointestine and achieve colon-specific drug delivery. The pellets prepared under optimal conditions resulted in delayed-release sigmoidal patterns with T(5%) (time for 5% drug release) of 5.1 - 7.8 h and T(90%) (time for 90% drug release) of 9.8 - 16.3 h. Further more, drug release was accelerated and T(90%) of the optimum formulation pellets decreased to 9.0 - 14.5 h in pH 6.5 phosphate buffer with hydrolase. It is concluded that mixed coating of guar gum and ethylcellulose is able to provide protection of the drug load in the upper gastrointestinal tract, while allowing enzymatic breakdown of the hybrid coat to release the drug load in the colon.
Cellulose ; administration & dosage ; analogs & derivatives ; Colon ; metabolism ; Drug Delivery Systems ; Fluorouracil ; administration & dosage ; chemistry ; Galactans ; administration & dosage ; Mannans ; administration & dosage ; Plant Gums ; administration & dosage