title: Ineffectiveness of sequential high dose methotrexate and 5-fluorouracil combined with epirubicin (FEMTX regimen) as a salvage therapy in advanced colorectal cancers and other gastrointestinal tumors.
abstract: The combination of sequential high dose methotrexate and 5-fluorouracil (FU) combined with epirubicin (FEMTX regimen) has shown some clinical efficiency as a first line therapy in advanced gastric cancer. We evaluated the therapeutic activity of this combination in advanced colorectal cancer patients who failed the FU + folinic acid regimen, and in advanced gastrointestinal cancer situation where no standard regimen is available. Twelve patients with measurable metastatic colorectal cancer refractory to first line (n = 6) or second line (n = 6) chemotherapy, as well as 9 patients with advanced gastrointestinal cancer, entered this pragmatic pilot study. Eighty-six per cent and 38% of the patients experienced severe haematological or non-haematological toxicities, respectively. Four patients were not evaluable for response due to their early departure from the scheme due to acute toxic events (n = 3) or toxic death (n = 1). No objective response was observed, but 9 stabilisations and 8 progressive diseases were noted. The FEMTX regimen is not of clinical value as a salvage therapy in colorectal and gastrointestinal cancer, because of its toxicity and its lack of efficacy.
authors.affiliation: Département d'Oncologie Médicale, Centre Oscar Lambret (Northern France Cancer Center), Lille, France.
authors.forename: A
authors.initials: A
authors.lastname: Adenis
authors.forename: N
authors.initials: N
authors.lastname: Leriche
authors.forename: J M
authors.initials: JM
authors.lastname: Pion
authors.forename: L
authors.initials: L
authors.lastname: Vanlemmens
authors.forename: J
authors.initials: J
authors.lastname: Bonneterre
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D015179:Colorectal Neoplasms / Q000188:drug therapy*; D015251:Epirubicin / Q000008:administration & dosage; D004938:Esophageal Neoplasms / Q000188:drug therapy; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000627:therapeutic use; D005770:Gastrointestinal Neoplasms / Q000188:drug therapy*; D006801:Humans; D002955:Leucovorin / Q000627:therapeutic use; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D010166:Palliative Care; D010190:Pancreatic Neoplasms / Q000188:drug therapy; D010865:Pilot Projects; D016879:Salvage Therapy; D017211:Treatment Failure
chemical_list: D015251:Epirubicin; D002955:Leucovorin; D005472:Fluorouracil; D008727:Methotrexate