FOLFIRI with bevacizumab chemotherapy for a patient with recurrence of rectal cancer under haemodialysis for chronic renal failure

Hiroki Hoshino, Yoshiyuki Ishii, Hirotoshi Hasegawa, Takashi Endo, Hiroki Ochiai, Yoshinori Hoshino, Atsushi Matsunaga, Kohei Shigeta, Yuki Seo, Go Hoshino, Yuukou Kitagawa

Research output: Contribution to journalArticle

Abstract

As pharmacokinetics in patients undergoing haemodialysis is different from patients with normal renal function, it remains unclear whether chemotherapy can be performed safely for patients with haemodialysis as well as those who have normal renal function. Here, we report a case with recurrence of rectal cancer who received FOLFIRI with bevacizumab chemotherapy under haemodialysis, and obtained good tumor control. A 47-year-old woman had undergone haemodialysis for 10 years due to chronic renal failure. At 45 years of age, she received abdominoperineal resection due to rectal cancer (pStage II). Four months after the surgery, liver metastasis was found, for which partial resection of the liver and adjuvant chemotherapy [UFT (400 mg/body)/UZEL (75 mg/body)] were performed. Eighteen months after the liver resection, multiple lung metastases were found. Therefore, intensive chemotherapy using FOLFIRI (CPT-11: 90 mg/m 2) with bevacizumab (2.5 mg/m 2) was performed. Severe neutropenia (grade 3, 4), but not non-hematologic adverse events such as diarrhea and bevacizumab-specific adverse events, was observed. As she did not recover easily from neutropenia in spite of treatment with G-CSF, a dose reduction of the FOLFIRI regimen was gradually performed. Although chemotherapy was conducted approximately monthly, the tumor response reflected a stable disease 8 months after 8 courses of chemotherapy. We suggest that it is important to investigate the pharmacokinetics of toxic agents such as CPT-11, (SN38) for dose modification, and for the safe and continuous chemotherapy of patients receiving haemodialysis.

Original languageEnglish
Pages (from-to)983-986
Number of pages4
JournalJapanese Journal of Cancer and Chemotherapy
Volume39
Issue number6
Publication statusPublished - 2012 Jun

Fingerprint

Rectal Neoplasms
Chronic Kidney Failure
Renal Dialysis
irinotecan
Recurrence
Drug Therapy
Neutropenia
Liver
Pharmacokinetics
Neoplasm Metastasis
Kidney
Poisons
Granulocyte Colony-Stimulating Factor
Adjuvant Chemotherapy
Bevacizumab
Diarrhea
Neoplasms
Lung

Keywords

  • Bevacizumab
  • FOLFIRI
  • Haemodialysis

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

FOLFIRI with bevacizumab chemotherapy for a patient with recurrence of rectal cancer under haemodialysis for chronic renal failure. / Hoshino, Hiroki; Ishii, Yoshiyuki; Hasegawa, Hirotoshi; Endo, Takashi; Ochiai, Hiroki; Hoshino, Yoshinori; Matsunaga, Atsushi; Shigeta, Kohei; Seo, Yuki; Hoshino, Go; Kitagawa, Yuukou.

In: Japanese Journal of Cancer and Chemotherapy, Vol. 39, No. 6, 06.2012, p. 983-986.

Research output: Contribution to journalArticle

Hoshino, H, Ishii, Y, Hasegawa, H, Endo, T, Ochiai, H, Hoshino, Y, Matsunaga, A, Shigeta, K, Seo, Y, Hoshino, G & Kitagawa, Y 2012, 'FOLFIRI with bevacizumab chemotherapy for a patient with recurrence of rectal cancer under haemodialysis for chronic renal failure', Japanese Journal of Cancer and Chemotherapy, vol. 39, no. 6, pp. 983-986.
Hoshino, Hiroki ; Ishii, Yoshiyuki ; Hasegawa, Hirotoshi ; Endo, Takashi ; Ochiai, Hiroki ; Hoshino, Yoshinori ; Matsunaga, Atsushi ; Shigeta, Kohei ; Seo, Yuki ; Hoshino, Go ; Kitagawa, Yuukou. / FOLFIRI with bevacizumab chemotherapy for a patient with recurrence of rectal cancer under haemodialysis for chronic renal failure. In: Japanese Journal of Cancer and Chemotherapy. 2012 ; Vol. 39, No. 6. pp. 983-986.
@article{22a045a7c997426f9cd8c33f17659b44,
title = "FOLFIRI with bevacizumab chemotherapy for a patient with recurrence of rectal cancer under haemodialysis for chronic renal failure",
abstract = "As pharmacokinetics in patients undergoing haemodialysis is different from patients with normal renal function, it remains unclear whether chemotherapy can be performed safely for patients with haemodialysis as well as those who have normal renal function. Here, we report a case with recurrence of rectal cancer who received FOLFIRI with bevacizumab chemotherapy under haemodialysis, and obtained good tumor control. A 47-year-old woman had undergone haemodialysis for 10 years due to chronic renal failure. At 45 years of age, she received abdominoperineal resection due to rectal cancer (pStage II). Four months after the surgery, liver metastasis was found, for which partial resection of the liver and adjuvant chemotherapy [UFT (400 mg/body)/UZEL (75 mg/body)] were performed. Eighteen months after the liver resection, multiple lung metastases were found. Therefore, intensive chemotherapy using FOLFIRI (CPT-11: 90 mg/m 2) with bevacizumab (2.5 mg/m 2) was performed. Severe neutropenia (grade 3, 4), but not non-hematologic adverse events such as diarrhea and bevacizumab-specific adverse events, was observed. As she did not recover easily from neutropenia in spite of treatment with G-CSF, a dose reduction of the FOLFIRI regimen was gradually performed. Although chemotherapy was conducted approximately monthly, the tumor response reflected a stable disease 8 months after 8 courses of chemotherapy. We suggest that it is important to investigate the pharmacokinetics of toxic agents such as CPT-11, (SN38) for dose modification, and for the safe and continuous chemotherapy of patients receiving haemodialysis.",
keywords = "Bevacizumab, FOLFIRI, Haemodialysis",
author = "Hiroki Hoshino and Yoshiyuki Ishii and Hirotoshi Hasegawa and Takashi Endo and Hiroki Ochiai and Yoshinori Hoshino and Atsushi Matsunaga and Kohei Shigeta and Yuki Seo and Go Hoshino and Yuukou Kitagawa",
year = "2012",
month = "6",
language = "English",
volume = "39",
pages = "983--986",
journal = "Japanese Journal of Cancer and Chemotherapy",
issn = "0385-0684",
publisher = "Japanese Journal of Cancer and Chemotherapy Publishers Inc.",
number = "6",

}

TY - JOUR

T1 - FOLFIRI with bevacizumab chemotherapy for a patient with recurrence of rectal cancer under haemodialysis for chronic renal failure

AU - Hoshino, Hiroki

AU - Ishii, Yoshiyuki

AU - Hasegawa, Hirotoshi

AU - Endo, Takashi

AU - Ochiai, Hiroki

AU - Hoshino, Yoshinori

AU - Matsunaga, Atsushi

AU - Shigeta, Kohei

AU - Seo, Yuki

AU - Hoshino, Go

AU - Kitagawa, Yuukou

PY - 2012/6

Y1 - 2012/6

N2 - As pharmacokinetics in patients undergoing haemodialysis is different from patients with normal renal function, it remains unclear whether chemotherapy can be performed safely for patients with haemodialysis as well as those who have normal renal function. Here, we report a case with recurrence of rectal cancer who received FOLFIRI with bevacizumab chemotherapy under haemodialysis, and obtained good tumor control. A 47-year-old woman had undergone haemodialysis for 10 years due to chronic renal failure. At 45 years of age, she received abdominoperineal resection due to rectal cancer (pStage II). Four months after the surgery, liver metastasis was found, for which partial resection of the liver and adjuvant chemotherapy [UFT (400 mg/body)/UZEL (75 mg/body)] were performed. Eighteen months after the liver resection, multiple lung metastases were found. Therefore, intensive chemotherapy using FOLFIRI (CPT-11: 90 mg/m 2) with bevacizumab (2.5 mg/m 2) was performed. Severe neutropenia (grade 3, 4), but not non-hematologic adverse events such as diarrhea and bevacizumab-specific adverse events, was observed. As she did not recover easily from neutropenia in spite of treatment with G-CSF, a dose reduction of the FOLFIRI regimen was gradually performed. Although chemotherapy was conducted approximately monthly, the tumor response reflected a stable disease 8 months after 8 courses of chemotherapy. We suggest that it is important to investigate the pharmacokinetics of toxic agents such as CPT-11, (SN38) for dose modification, and for the safe and continuous chemotherapy of patients receiving haemodialysis.

AB - As pharmacokinetics in patients undergoing haemodialysis is different from patients with normal renal function, it remains unclear whether chemotherapy can be performed safely for patients with haemodialysis as well as those who have normal renal function. Here, we report a case with recurrence of rectal cancer who received FOLFIRI with bevacizumab chemotherapy under haemodialysis, and obtained good tumor control. A 47-year-old woman had undergone haemodialysis for 10 years due to chronic renal failure. At 45 years of age, she received abdominoperineal resection due to rectal cancer (pStage II). Four months after the surgery, liver metastasis was found, for which partial resection of the liver and adjuvant chemotherapy [UFT (400 mg/body)/UZEL (75 mg/body)] were performed. Eighteen months after the liver resection, multiple lung metastases were found. Therefore, intensive chemotherapy using FOLFIRI (CPT-11: 90 mg/m 2) with bevacizumab (2.5 mg/m 2) was performed. Severe neutropenia (grade 3, 4), but not non-hematologic adverse events such as diarrhea and bevacizumab-specific adverse events, was observed. As she did not recover easily from neutropenia in spite of treatment with G-CSF, a dose reduction of the FOLFIRI regimen was gradually performed. Although chemotherapy was conducted approximately monthly, the tumor response reflected a stable disease 8 months after 8 courses of chemotherapy. We suggest that it is important to investigate the pharmacokinetics of toxic agents such as CPT-11, (SN38) for dose modification, and for the safe and continuous chemotherapy of patients receiving haemodialysis.

KW - Bevacizumab

KW - FOLFIRI

KW - Haemodialysis

UR - http://www.scopus.com/inward/record.url?scp=84865497731&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84865497731&partnerID=8YFLogxK

M3 - Article

C2 - 22705698

AN - SCOPUS:84865497731

VL - 39

SP - 983

EP - 986

JO - Japanese Journal of Cancer and Chemotherapy

JF - Japanese Journal of Cancer and Chemotherapy

SN - 0385-0684

IS - 6

ER -