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Published on : Nov 20, 2017

World over, notably in various developed and emerging economies, clinical research continue to aim for improving the efficacy and safety of current oncology treatments. In a randomized phase-3 trial enrolling 650 patients aged 20 or more from across several nations, to assess the efficacy of the new regiment, known as combined capecitabine and irinotecan (XELIRI), versus FOLFIRI, was investigated. The researchers found that XELIRI is not inferior to the standard FOLFIRI regimen, vis-à-vis overall survival rate, but can’t replace the latter owing to significant concerns of noted toxicity. However, they could demonstrate that a modified FOLFIRI (m-FOLFIRI) with a combination of bevacizumab, can prove promising as a safe and effective second line therapy for metastatic CRC, without affecting the survival rates.

Standard Chemotherapy Regimen for CRC may Cause High Toxicity or Disease Progression after Chemo

The m-XELIRI is developed by reducing the dose of doses of irinotecan and capecitabine and bodes well for CRC second line of treatment, in terms of favorable tolerability and efficacy.

The management of patients with metastatic colorectal cancer (CRC) pose a significant challenge, given the patient’s inconvenience with the primary line of treatments. These are marked by high toxicity and rapid disease progression or even the relapse within the three months after the final dose of adjuvant chemotherapy is administered. FOLFIRI, a popular and standard chemotherapy regimen for CRC, is not without discomfort to patients and affects their tolerance. Hence investigators have harped on a second line backbone therapy for the managements of CRC.

The multicentre, open-label trail was developed using the Asian XELIRI ProjecT (AXEPT), and the scientists reported the favorable findings at the ESMO Asia 2017 Congress. The scientists have called for further research, including biomarker analysis, for better understanding the quality of life data obtained in the trials. Pharmacogenetic studies could also prove helpful in understanding the marked difference between irinotecan toxicity profile of Asian and non-Asian patient populations.