First-line FOLFOXIRI-based Chemotherapy for Unresectable Metastatic Colorectal Cancer: Real-world Outcomes, Safety, and Conversion Surgery

BACKGROUND/AIM: In Japan, contemporary real-world data that simultaneously assess effectiveness, safety, conversion feasibility, and long-term outcomes of first-line FOLFOXIRI-based chemotherapy for unresectable metastatic colorectal cancer (mCRC) remain limited. Here, we aimed to evaluate the real-world efficacy, safety, and long-term outcomes of this treatment as well as to identify factors associated with conversion surgery. PATIENTS AND METHODS: We conducted a retrospective single-center cohort study of consecutive patients with first-line FOLFOXIRI (±targeted agent). Progression-free survival (PFS) encompassed the entire first-line treatment period. Survival outcomes were analyzed using Kaplan-Meier and log-rank tests, with hazard ratios (HRs) estimated by Cox models. Adverse events (AEs) were graded according to CTCAE v5.0. RESULTS: -mutant tumors. Grade ≥3 neutropenia and febrile neutropenia occurred in 72.9% and 25.4% of patients, respectively; severe non-hematological AEs were rare, and no treatment-related deaths occurred. CONCLUSION: status.