RESUMO
Purpose: A proportion of patients with metastatic colorectal cancer (mCRC) are still able to continue with active therapy after their progression to fluoropyrimidines, oxaliplatin, and irinotecan regimens. Studies suggest that gemcitabine and fluoropyrimidines are synergic antimetabolites. The purpose was to evaluate gemcitabinecapecitabine (GemCape) in heavily pretreated mCRC and to thus assess possible predictive factors for progression-free survival (PFS) and overall survival (OS). Patients and methods: This analysis was performed on 119 evaluable patients pretreated with fluoropyrimidines, oxaliplatin, irinotecan, and biological agents between June 2001 and July 2011. Patients received gemcitabine 1,000 mg/m2 day 1 and capecitabine 1,000 mg/m2 bid for 7 days every 2 weeks. Results: The general characteristics were ECOG 01, 89 %; male, 68 %, and median age 63 years. In total, 61 % had received two chemotherapy lines, while 39 % had received three or more. Objective response rates and stable disease rates at 3 months were 6.72 and 37.81 %, equalling a clinical benefit of 44.53 %. The median PFS and OS were 2.87 months [95 % confidence interval (CI) 2.533.17 months] and 6.53 months (95 % CI 5.338.77), respectively. The most frequent toxicities were grades 12, anemia (22 %), thrombocytopenia (10 %), and handfoot syndrome (9 %); grade ≥3, diarrhea (2 %), with no treatment-related discontinuations. No treatment-related deaths were reported. Statistical significance was obtained by subgroups, assessing clinical benefits and objective responses for PFS and OS. Moreover, patients under 65 tended to have a better PFS. Conclusion: These data suggest that GemCape is a tolerable and feasible regimen, associated with clinical benefit in non-selected, heavily pretreated, mCRC patients (AU)
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Assuntos
Adulto , Feminino , Humanos , Masculino , Neoplasias Colorretais/complicações , Neoplasias Colorretais/tratamento farmacológico , Antineoplásicos/uso terapêutico , Metástase Neoplásica/tratamento farmacológico , Progressão da Doença , Tratamento Farmacológico/instrumentação , Tratamento Farmacológico/métodos , Sobrevivência , Tomografia Computadorizada de Emissão/métodos , Anticorpos Monoclonais/efeitos adversos , Anticorpos Monoclonais/isolamento & purificação , Análise MultivariadaRESUMO
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