Chemotherapy rechallenge in metastatic colon cancer: A case report and literature review

Table 1 Summary of studies assessing the efficacy of oxaliplatin-based rechallenge therapy against metastatic colorectal cancer

Ref.	Prior lines of chemotherapy	Patient cohort	Treatment regimen	PFS (months)	OS (months)
Suenaga et al[11]	Oxaliplatin-based therapy: First-line: 26 (78.8%); Second-line 7 (21.2%). Molecular-targeted therapy: None: 1 (3.0%); Bevacizumab: 27 (81.8%); Cetuximab or Panitumumab: 19 (57.6%)	33 patients, previously received oxaliplatin and irinotecan, had stable disease, and disease progression ≥ 6 mo	FOLFOX6: 33 (100%)	3.2	9.8
Yang et al[13]	Oxaliplatin-based therapy: First-line: 76 (80.0%); Second-line 19 (20.0%). Oxaliplatin rechallenge therapy: Third-line: 78 (82.1%); Fourth-line: 13 (13.7%); Fifth or more: 4 (4.2%). Control arm: Anti-EGFR + irinotecan: 29 (100%)	Rechallenge arm: 95 patients received who received oxaliplatin in the first/second-line and were rechallenged as a third or later line of therapy	mFOLFOX6: 70 (73.7%); XELOX: 19 (20%); Other: 6 (6.3)	1.7a	12.2
		Control arm: 29 patients received anti-EGFR and irinotecan therapy	Anti-EGFR + irinotecan: 29 (100%)		11.4
Köstek et al[14]	All patients received two lines of chemotherapy of any of the following combinations: (FOLFIRI, FOLRFIRI/XELIRI, FOLFOX/XELOX, capecitabine, FUFA/capecitabine) monotherapy or combined with biologic agents bevacizumab/cetuximab/panitumab	Regorafenib arm: 73	Regorafenib	3.4	6.6
		Rechallenge arm: 31; rechallenge therapy was identified as re-using a regimen that was previously administered to patients and had obtained disease control	FOLFOX + cetuximab: 8, FOLFOX + bevacizumab: 6, FOLFOX: 4, FOLFIRI: 2, FOLFIRI + cetuximab: 3, capecitabine: 2, FOLFOX + panitumab: 1, FOLFIRI + bevacizumab: 1, FUFA + bevacizumab: 1, capecitabine + bevacizumab: 1, XELOX + bevacizumab: 1, FOLFIRINOX: 1	9.2	12.0
Fernandes et al[16]	Patients with documented progression to regimens containing oxaliplatin, irinotecan, and 5-FU (most patients received at least three regimens)	Rechallenge arm: 21 patients who were rechallenged with either FOLFIRINOX or FOLFOXIRI	FOLFIRINOX: 13 (61.9%); FOLFOXIRI: 8 (38.1%)	4.0	8.6
Townsend et al[17]	Patients identified to received oxaliplatin previously. Prior lines of chemotherapy before oxaliplatin rechallenge (information on prior regimen was not provided): 4 lines for 2 patients, 3 lines for 6 patients, 2 lines for 8 patients, 1 line for 4 patients	Rechallenge arm: 20 patients who were rechallenged with FOX therapy	FOX: 20	3.7	7.8
Sgouros et al[18]	Patients previously treated with IROX with refractory disease (median prior lines of chemotherapy: 3)	Rechallenge arm: 25 patients who were rechallenged with IROX therapy	Irinotecan (180 mg/m2/135 mg/m2) and oxaliplatin (85 mg/m2/65 mg/m2) every two weeks	3.0	7.0

^aBest PFS for all oxaliplatin based rechallenge regimens evaluated.

FOLFOX: Folinic acid, 5-fluorouracil, and Oxaliplatin; EGFR: Epidermal growth factor receptor; XELOX: Capecitabine and oxaliplatin; FOLFIRI: Folinic acid, 5-fluorouracil, and irinotecan; XELIRI: Capecitabine and irinotecan; FUFA: Folinic acid and 5-fluorouracil; FOX: Oxaliplatin and fluoropyrimidine; 5-FU: 5-Fluorouracil; IROX: Irinotecan with oxaliplatin; FOLFOXIRI: 5-Fluorouracil, leucovorin, oxaliplatin, and irinotecan; FOLFIRINOX: Oxaliplatin, irinotecan, fluorouracil, and leucovorin. PFS: Progression free survival; OS: Overall survival; NR: Not reported.