The Use of Combination Oral Chemotherapy to Enable Quality Day-Patient Care among Colorectal Cancer (CRC) Patients with Unresectable Liver-only Metastases

This abstract has open access
Abstract Summary
Abstract ID :
Submission Type
Presentation Upload :
If the file does not load, click here to open/download the file.
Authors (including presenting author) :
Wong SMN1, Chiang CLA2, Yeung SYC1, Lee SFM1, Lee ASF1, Wong CSF1
Affiliation :
1 Department of Clinical Oncology, Tuen Mun Hospital, Hong Kong 2 Department of Clinical Oncology, HKU-Shenzhen Hospital and the University of Hong Kong, Hong Kong
Introduction :
While the use conversion chemotherapy regimen comprising infusional 5-fluorouracil (5FU), Irinotecan, and Cetuximab (FOLIRI-C) has been well established to improve R0 resection and survival among colorectal cancer patients with unresectable liver-only metastases, few explored the alternative 5FU oral counterpart - Capecitabine, in combination use. The Tuen Mun Hospital Clinical Oncology Team developed a multi-disciplinary, day-patient service model with mCAPIRI-C (Capecitabine, Irinotecan, Cetuximab) to spare in-patient admissions, ease administration, enhance efficiency, and hence improve overall patients’ care.
Objectives :
(1) To evaluate long term safety and efficacy of mCAPIRI-C among CRC patients with unresectable liver-only metastases in comparison to international standards (2) To demonstrate the implementation of a multidisciplinary, day-patient service model to enhance robustness and to deliver quality healthcare
Methodology :
We performed a single-centre, retrospective cohort investigating the clinical outcomes of mCAPIRI-C among CRC patients with upfront unresectable liver-only metastases identified at Hepatobiliary Multidisciplinary meetings of Tuen Mun Hospital from June 2012 to June 2018. Serial evaluation of clinical, biochemical and radiological results were performed.
Result & Outcome :
mCAPIRI-C has achieved superior conversion rate of 62% among eligible patients (n=47), of which 45% subsequently underwent R0 resection and 13% underwent other curative interventions [radiofrequency ablation (RFA) / stereotactic ablative radiotherapy (SBRT)]. Overall radiological response rate was excellent (83%), of which 6% achieved complete response. Of those who have received potentially curative therapies (surgery/RFA/SBRT), a significant progression free survival gain of 15.1 months (p< 0.001) was seen, while overall survival has not been reached (p=0.002). Treatment was well tolerated with no treatment-related 60-day or 30-day post-operative mortalities, and had a strikingly low occurrence of grade 3 or above toxicities. With a median of 8 chemotherapy cycles received per patient, a total of 940 hospital admission days was saved, translating into improved patient ambulation and reduced in-patient load. We have demonstrated safety and efficacy of mCAPIRI-C that exceeds international standards using FOLIRI-C. It has laid a solid foundation to support the use of this day-patient regime among other CRC indications to maximize patients’ benefit and enhance service robustness.

Abstracts With Same Type

Abstract ID
Abstract Title
Abstract Topic
Submission Type
Primary Author
Clinical Safety and Quality Service I
HA Staff
Maria SINN Dr
Enhancing Partnership with Patients and Community
HA Staff
Donna TSE
Enhancing Partnership with Patients and Community
HA Staff
Clinical Safety and Quality Service II
HA Staff
547 visits