Retrospective Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jun 21, 2016; 22(23): 5400-5405
Published online Jun 21, 2016. doi: 10.3748/wjg.v22.i23.5400
Last line therapy with sorafenib in colorectal cancer: A retrospective analysis
Ksenia Martchenko, Irene Schmidtmann, Thomas Thomaidis, Verena Thole, Peter R Galle, Marc Becker, Markus Möhler, Thomas C Wehler, Carl C Schimanski
Ksenia Martchenko, Carl C Schimanski, Department of Internal Medicine, Marienhospital, 64285 Darmstadt, Germany
Irene Schmidtmann, Institute of Medical Biostatistics, Epidemiology and Informatics, Johannes Gutenberg University Hospital of Mainz, 55131 Mainz, Germany
Thomas Thomaidis, Peter R Galle, Markus Möhler, Carl C Schimanski, First Department of Internal Medicine, Johannes Gutenberg University Hospital of Mainz, 55131 Mainz, Germany
Verena Thole, Department of Internal Medicine, Katholische Kliniken Mainz, 55131 Mainz, Germany
Marc Becker, Institute of Pathology, Saarland University Medical Center, 66421 Homburg, Germany
Thomas C Wehler, Third Department of Internal Medicine, Johannes Gutenberg University Hospital of Mainz, 55131 Mainz, Germany
Author contributions: Wehler TC and Schimanski CC wrote the paper and supervised the study; Martchenko K and Schmidtmann I performed research and analyzed the data, Thomaidis T and Thole V contributed to the analysis; Becker M contributed to the analysis and wrote the paper; Galle PR and Möhler M provided clinical advice; Martchenko K, Schmidtmann I contributed equally to this work; Wehler TC, Schimanski CC are joint senior authors.
Conflict-of-interest statement: We declare that there are no conflicts of interests. Carl Schimanski received research funding, Markus Moehler received speech honoraria, Peter R Galle consulting and speech honoraria.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Carl C Schimanski, Professor, Department of Internal Medicine, Marienhospital, Martinspfad 72, 64285 Darmstadt, Germany. c.schimanski@marienhospital-darmstadt.de
Telephone: +49-6151-406230 Fax: +49-6151-406232
Received: August 18, 2015
Peer-review started: August 18, 2015
First decision: November 26, 2015
Revised: January 12, 2016
Accepted: January 30, 2016
Article in press: January 30, 2016
Published online: June 21, 2016
Abstract

AIM: To analyze the efficacy of last line sorafenib treatment in colorectal cancer patients.

METHODS: All patients receiving chemotherapy for colorectal cancer in the outpatient clinic of the University of Mainz since 2006 were retrospectively analyzed for last line sorafenib exposure. Charts of identified patients were analyzed for clinic-pathological parameters, like data on gender, age, date of initial diagnosis, UICC stage, number and kind of the pre-therapies, therapy start and end of sorafenib, sorafenib mediated treatment cessation, side effects, response rates, time to progression and overall survival.

RESULTS: Ten patients with a median of 3.0 prior chemotherapy lines had received a last line sorafenib therapy either alone (10%) or in combination with 5-fluorouracil derivates (90%). All patients suffered from colorectal cancer stage UICC 4 and were routinely seen in 2-wk intervals in the oncology outpatient clinic. Median duration of treatment was 142.0 d. At 8 wk 80% of patients showed stable disease but we did not observe any remissions. Median time to progression was 140.5 d (4.7 mo), while median overall survival reached 176.5 d. One patient ceased treatment due to side effects. Reason for treatment stop was bleeding complication in one case and non-specified sorafenib intolerance in another case. Due to the retrospective approach we did not further quantify side effects.

CONCLUSION: This retrospective analysis encourages further investigation of sorafenib in colorectal cancer last line therapy.

Keywords: Colorectal cancer, Sorafenib, Regorafenib, Chemotherapy, Last line

Core tip: In this restrospective analysis we demonstrate that sorafenib monotherapy or in combination with 5-fluorouracil derivates seems to be feasible. Eighty percent of the patients showed stable disease with a median time to progression of 140.5 d and acceptable toxicity profile. In our eyes, the reported overall as well as progression free survival under sorafenib treatment are of clinical and financial interest.