Continuous 5-fluorouracil in the treatment of breast cancer.
Prolonged infusions of 5-fluorouracil (5-FU) have been used since the early 1960s, but recently there has been a major resurgence of interest, partly because of the advent of electronically controlled portable infusion pumps. This paper looks at the published data on continuously infused 5-FU in breast cancer. As a single agent, bolus 5-FU has a response rate of around 25%; this includes many patients in older series who were chemotherapy naive. The overall response rate across all the studies with continuously infused 5-FU is 29%. However, the majority of these patients were heavily pretreated, and response rates of up to 54% have been reported. What is more encouraging is the response rate in combination chemotherapy--even for pretreated patients with metastatic disease, response rates up to 89% have been found. However, this level of benefit brings a new toxicity--palmar--plantar erythrodysaesthesia; and of course myelotoxicity still remains a problem in the combination regimens. Randomised trials to assess the role of infusional 5-FU are now indicated.
ICRF Department of Medical Oncology, Western General Hospital, Edinburgh, UK.
D A
DA
Cameron
H
H
Gabra
R C
RC
Leonard
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy*; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D007165:Immunosuppression Therapy; D007260:Infusion Pumps; D007262:Infusions, Intravenous
D005472:Fluorouracil