1
|
Cainap C, Ungur RA, Bochis OV, Achimas P, Vlad C, Havasi A, Vidrean A, Farcas A, Tat T, Gherman A, Piciu A, Bota M, Constantin AM, Pop LA, Maniu D, Crisan O, Cioban CV, Balacescu O, Coza O, Balacescu L, Marta MM, Dronca E, Cainap S. Partnering bevacizumab with irinotecan as first line-therapy of metastatic colorectal cancer improves progression free survival-A retrospective analysis. PLoS One 2021; 16:e0248922. [PMID: 33909622 PMCID: PMC8081186 DOI: 10.1371/journal.pone.0248922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 03/08/2021] [Indexed: 12/24/2022] Open
Abstract
Colorectal cancer remains one of the most frequent malignancies (third place at both genders) worldwide in the last decade, owing to significant changes in modern dietary habits. Approximately half of the patients develop metastases during the course of their disease. The available therapeutic armamentarium is constantly evolving, raising questions regarding the best approach for improving survival. Bevacizumab remains one of the most widely used therapies for treating metastatic colorectal cancer and can be used after progression. This study aimed to identify the best chemotherapy partner for bevacizumab after progression. We performed a retrospective analysis of patients with metastatic colorectal cancer who were treated with bevacizumab as first- and second-line chemotherapy. Data were collected for 151 patients, 40 of whom were treated with double-dose bevacizumab after the first progression. The two standard chemotherapy regimens combined with bevacizumab were FOLFIRI/CAPIRI and FOLFOX4/CAPEOX. The initiation of first-line treatment with irinotecan-based chemotherapy improved progression-free survival and time to treatment failure but not overall survival. After the first progression, retreatment with the same regimen as that used in the induction phase was the best approach for improving overall survival (median overall survival: 46.5 vs. 27.0 months for the same vs. switched strategy, respectively). No correlations were observed between the dose intensity of irinotecan, oxaliplatin, 5-fluorouracil, or bevacizumab and the overall survival, progression-free survival in the first-/second-line treatment, and time to treatment failure. Interaction between an irinotecan-based regimen as a second-line treatment and double-dose bevacizumab after progression was associated with an improved overall survival (p = 0.06). Initiating systemic treatment with an irinotecan-based regimen in combination with bevacizumab improved the progression-free survival in the first-line treatment and time to treatment failure. In terms of overall survival, bevacizumab treatment after the first progression is better partnered with the same regimen as that used in the induction phase.
Collapse
Affiliation(s)
- Calin Cainap
- Ion Chiricuta Institute of Oncology, Cluj-Napoca, Romania
- Department of Oncology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Rodica Ana Ungur
- Department of Medical Specialties, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
- * E-mail:
| | | | - Patriciu Achimas
- Ion Chiricuta Institute of Oncology, Cluj-Napoca, Romania
- Department of Oncology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Catalin Vlad
- Ion Chiricuta Institute of Oncology, Cluj-Napoca, Romania
- Department of Oncology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Andrei Havasi
- Ion Chiricuta Institute of Oncology, Cluj-Napoca, Romania
| | | | - Anca Farcas
- Department of Medical Specialties, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Tiberiu Tat
- Ion Chiricuta Institute of Oncology, Cluj-Napoca, Romania
| | - Alexandra Gherman
- Ion Chiricuta Institute of Oncology, Cluj-Napoca, Romania
- Department of Oncology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Andra Piciu
- Ion Chiricuta Institute of Oncology, Cluj-Napoca, Romania
- Department of Oncology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Madalina Bota
- Department of Mother and Child, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Anne-Marie Constantin
- Department of Morphological Sciences, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Laura Ancuta Pop
- Department of Molecular Sciences, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Dana Maniu
- Faculty of Physics, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Ovidiu Crisan
- Faculty of Pharmacy, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Cosmin Vasile Cioban
- Faculty of Dental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | | | - Ovidiu Coza
- Ion Chiricuta Institute of Oncology, Cluj-Napoca, Romania
- Department of Oncology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | | | - Monica Mihaela Marta
- Department of Medical Education, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Eleonora Dronca
- Department of Molecular Sciences, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Simona Cainap
- Department of Mother and Child, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| |
Collapse
|
2
|
Braicu E, Sehouli J, Richter R, Vergote I, Concin N, van Nieuwenhuysen E, Achimas P, Berger A, Fetica B, Mahner S, Glajzer J, Papadia A, Woelber L, Gasparri M, Vanderstichele A, Benedetti Panici P, Mueller M, Ruscito I, Zimmer J, Woopen H. Preoperative c-reactive protein and thrombocyte count as potential markers for longterm survival in ovarian cancer. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy285.171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
3
|
Zaharie F, Ciorogar G, Zaharie R, Mocan T, Zdrehus C, Mocan L, Berindan-Neagoe I, Achimas P, Iancu C, Tomus C. Laparoscopic rectal resection versus conventional open approach for rectal cancer - a 4-year experience of a single center. J BUON 2015; 20:1447-1455. [PMID: 26854440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
PURPOSE This study was carried out to compare the therapeutic outcomes and complications of the laparoscopic and the conventional open surgery technique used for treating rectal cancer. Another goal was to find the fastest and most accurate method of treatment for rectal cancer, along with establishing the advantages and disadvantages of the two surgical techniques, depending on cancer location and its stage. METHODS A total of 172 patients diagnosed with rectal cancer and hospitalized in the Department of Surgery III between January 1st 2008 and December 31st 2011 were studied. The laparoscopic approach was performed on 29 (16.8%) patients, and the remaining 143 (83.2%) underwent the conventional Miles/Lloyd-Davies abdominoperineal resection. A longitudinal study was conducted on patients with rectal resection, the used data being obtained from the database of the Department of Surgery III, hospital records, protocols and clinical charts of rectal cancer cases. RESULTS There were no statistically significant differences regarding symptoms, gender, age, body mass index (BMI), tumor site, TNM stage, intraoperative accidents, operative time, and postoperative mortality between the two groups. The laparoscopic group presented advantages regarding antibiotic and analgesic therapy, early mobilization, hospital stay, intraoperative blood loss, resuming oral nutrition, bowel transit resumption, postoperative complications and wound complications. CONCLUSION Laparoscopic abdominoperineal resection for rectal cancer is feasible, safe and effective. It can be safely performed by an experienced team, reducing the rate of postoperative complications, the need for blood transfusions, the adminstration of antibiotics and painkillers, allowing faster bowel transit resumption, shortening hospital stay and providing superior aesthetic results.
Collapse
Affiliation(s)
- Florin Zaharie
- Regional Institute of Gastroenterology and Hepatology "Octavian Fodor", Cluj-Napoca, and University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania
| | | | | | | | | | | | | | | | | | | |
Collapse
|
4
|
Eniu D, Nistor-Ciurba C, Rancea A, Ciuce C, Gheorghiu D, Hica I, Constantin I, Hopulele I, Achimas P, Lazar L. 178 POSTER Reconstruction with flaps in the cancer patient; 12 Years Experience in the “Ion Kiricuta” Oncologic Institute, Romania. Eur J Surg Oncol 2006. [DOI: 10.1016/s0748-7983(06)70613-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
|