According to an article recently published in the Journal of Clinical Oncology, reintroduction of Eloxatin® (oxapliatin)-based chemotherapy improves survival for patients with advanced colorectal cancer.

Colorectal cancer remains the second leading cause of cancer-related deaths in the United States. Advanced colorectal cancer refers to cancer that has spread from its site of origin to distant sites in the body. Treatment including the chemotherapy agent Eloxatin is often used for the treatment of advanced colorectal cancer. Eloxatin is most commonly used with 5-fluorouracil and leucovorin, a combination referred to as FOLFOX.

A limitation of Eloxatin is that it is associated with a side effect called neuropathy, a condition affecting the signaling of nerves that results in pain, numbness, and loss of ability to control fine movements. Neuropathy from FOLFOX typically occurs in the hands and feet and often becomes so severe that treatment is discontinued.  Once treatment is discontinued for a while, neuropathy often reverses and sensory returns to normal.

Researchers have been evaluating the effectiveness of the reintroduction of Eloxatin after a period of discontinued treatment so that patients can recover from neuropathy.

Researchers from France, Spain, and Israel previously conducted a clinical trial, referred to as the OPTIMOX1 trial, to evaluate two different administration schedules of FOLFOX in the treatment of advanced colorectal cancer. This trial included 621 patients who were treated with one of two different schedules of FOLFOX: one group received FOLFOX until their disease progressed, and the other group received FOLFOX for a specified period of time, followed by treatment with fluorouracil/leucovorin, and finally reintroduction of FOLFOX.

Protocol, however, was not strictly followed in the OPTIMOX1 trial: several patients were not administered the planned reintroduction and patients in both groups received additional therapy. To determine more precise results that accounted for these changes in trial procedure, researchers reviewed trial data to investigate whether patients who received the planned reintroduction of FOLFOX experienced different outcomes compared with patients who received FOLFOX until cancer progression.

• Patients treated with reintroduction of FOLFOX had a 44% improved survival compared with patients who received FOLFOX until cancer progression.
• Medical centers in which greater numbers of patients were treated with reintroduction of FOLFOX demonstrated a significantly greater duration of median survival compared with medical centers in which fewer patients were treated with reintroduction of FOLFOX.
• Severe side effects were reduced among patients who were treated with reintroduction of FOLFOX compared to those who received continuous FOLOX until cancer progression.

The researchers concluded: “Oxaliplatin reintroduction is associated with improved survival in patients with advanced colorectal cancer.” Patients with colorectal cancer who are receiving treatment with FOLFOX may wish to speak with their physician regarding their individual risks and benefits of reintroduction of therapy.

Reference: de Gramont A, Buyse M, Abrahantes J, et al. Reintroduction of oxaliplatin is associated with improved survival in advanced colorectal cancer. Journal of Clinical Oncology. 2007;25: 3224-3229.

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