Biochemical modulation of 5-fluorouracil by folinic acid or alpha-interferon with and without other cytostatic drugs in gastric, esophageal, and pancreatic cancer.
5-Fluorouracil (5-FU) is one of the important antineoplastic agents for the treatment of gastrointestinal cancers. The biochemical modulation of 5-FU by various drugs has brought about the two combinations of 5-FU/folinic acid (FA) and 5-FU/alpha-interferon (IFN), which have shown clinical activity in phase II and III trials, especially in colorectal cancer. The experience with both combinations in upper gastrointestinal cancers, however, is limited. In esophageal cancer, two phase II studies with 5-FU/IFN reported seven (27%) objective remissions in 26 patients, indicating superiority of 5-FU/IFN over 5-FU monotherapy. Trials with 5-FU/FA alone are lacking in esophageal cancer. The modulation of 5-FU by IFN or FA failed to show clinically significant activity in pancreatic cancer. However, in gastric cancer, 5-FU/FA and 5-FU/IFN seem to induce higher complete and overall remission rates in advanced gastric cancer compared with 5-FU alone. With the daily times five schedule of 5-FU/FA, 27% objective remissions were achieved; in combination with other cytotoxic drugs, such as etoposide, anthracyclines, cisplatin, mitomycin, or methotrexate, objective response rates up to 50% and more were reported.
Wilke
H
H
Department of Internal Medicine (Cancer Research), Essen University Medical School, West German Cancer Center.
Stahl
M
M
Schmoll
H J
HJ
Preusser
P
P
Fink
U
U
Meyer
H J
HJ
Achterrath
W
W
Knipp
H
H
Köhne-Wömpner
C H
CH
Harstrick
A
A
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D004334:Drug Administration Schedule; D004938:Esophageal Neoplasms / Q000628:therapy*; D005472:Fluorouracil / Q000008:administration & dosage / Q000378:metabolism; D006801:Humans; D016898:Interferon-alpha / Q000008:administration & dosage; D002955:Leucovorin / Q000008:administration & dosage; D010190:Pancreatic Neoplasms / Q000628:therapy*; D013274:Stomach Neoplasms / Q000628:therapy*
D016898:Interferon-alpha; D002955:Leucovorin; D005472:Fluorouracil