Efficacy and Safety of Raltitrexed Combinations with Uracil-Tegafur or Mitomycin C as Salvage Treatment in Advanced Colorectal Cancer Patients: A Multicenter Study of Anatolian Society of Medical Oncology (ASMO)

Background: There is no standard treatment for patients with colorectal cancer (CRC) progressing afteririnotecan and oxaliplatin treatment. Here we aimed to retrospectively evaluate the efficacy and tolerability ofraltitrexed in combination with oral 5-fluoropyrimidine (uracil tegafur-UFT) or mitomycin C as salvage therapyin mCRC patients. Materials and
Methods: A total of 62 patients who had received raltitrexed combined withUFT or mitomycin C were identified between December 2008 and June 2013. They were given raltitrexed 2.6mg/m2 (max 5 mg) i.v. on day 1 in combination with either oral UFT 500 mg/day on days 1-14 every 3 weeks(group A) or mitomycin C 6 mg/m2 i.v. on day every 3 weeks (group B).
Results: Forty-two patients (67.7%)were in group A and 20 (32.2%) in group B. In 15 patients (24%) grade 3/4 toxicity was observed, resultingin dose reduction, and in 13 patients (20.9%) dose delay was necessary. The median progression free survival(PFS) was 3 months (95%CI 2.65-3.34) and median overall survival (OS) was 6 months (95%CI 2.09-9.90) inthe whole group. Median PFS was 3 months (95%CI 2.60-3.39) in group A vs 3 months (95%CI 1.64-4.35) ingroup B (p=0.90). Median OS was 6 months (95%CI 2.47-9.53) in group A vs 12 months (95%CI 2.83-21.1) ingroup B (p=0.46).
Conclusions: The combination of raltitrexed with UFT or mitomycin C seem to be a salvagetherapy option due to safety profile and moderate clinical activity in heavily-pretreated mCRC patients.