Care by Kampo medicine for toxicities of colorectal cancer chemotherapy: Effect of goshajinkigan (TJ-107) and powdered processed aconite root (TJ-3023) on oxaliplatin-related neurotoxicity, and effect of hangeshashinto (TJ-14) on CPT-11-related diarrhea.

601 Background: FOLFOX is standard therapy of advanced-stage colorectal cancer. Sensory neurotoxicity (SN) with oxaliplatin is its dose-limiting toxicity. We decided to use goshajinkigan (TJ-107) for prevention of oxaliplatin-related SN. We think that the main action is the one with powdered processed aconite root (TJ-3023). FOLFIRI is standard therapy too. But watery diarrhea is severe side effect. We decided to use hangeshashinto (TJ-14) for prevention of CPT-11-related watery diarrhea. Methods: The subjects were 66 patients with advanced-stage colorectal cancer. All 66 patients take TJ-107 (7.5g/day) every day from first oxaliptatin infusion day. Patients profiles were: Male/Female: 29/37, median age 69 years old (42∼84), PS0/1/2/3: 57/9/0/0, clinical stage IIIC/IV: 14/52. Oxaliplatin (85mg/m2) was given as FOLFOX4 (27case), mFOLFOX6 (34) and CapeOx (5). When SN was increased, TJ-3023 was added. TJ-3023 is ingredient of TJ-107. 12 patients had severe watery diarrhea due to FOLFIRI regimen. All 12 patients take TJ-14 (7.5g/day) from appearance of watery diarrhea. Patients profiles were: Male/Female: 8/4. Results: Total course number of FOLFOX/CapeOX was 595/21, and average number of FOLFOX/CapeOX was 8.46/4.2. Relative dose intensity of oxaliplatin were 37.6mg/m2/week. Medicine compliance of TJ-107 was 89%. 20 patients had grade 3 toxcity (neutropenia 18, thrombocytopenia 2). TTP is 8.14 months. Response Evaluation Criteria is CR/PR/SD/PD/NE:1/36/11/5/13. SN occurred in 43 patients (65.1%). TJ-3023 was added to 10 patients. SN was slightly decreased by TJ-3023. There was no neurotoxicity case with functional impairment in this study. By TJ-14, all 12 patients have a change for the better from grade 2 to grade 1 or 0 of diarrhea. There was no constipation cases. Conclusions: TJ-107 seem to prervent acute oxaliplatin-induced SN. TJ-3023 may be related to SN prervention mechanism. TJ-14 seem to prevent CPT-11-induced diarrhea. The continuance of chemotherapy for colorectal cancer can be expected by these Kampo medicine. No significant financial relationships to disclose.