title: Sequential methotrexate and 5-fluorouracil as second-line chemotherapy for advanced colorectal cancer patients pretreated with 5-fluorouracil and leucovorin: a GISCAD study.
abstract: The biochemical modulation of 5-fluorouracil (5-FU) by means of methotrexate (MTX) and 6-S leucovorin (LV) seems mainly directed at two different intracellular targets, supporting the hypothesis of possible non-cross resistance between these two methods of 5-FU potentiation. Thirty-one patients, all previously treated with 5-FU and LV for advanced colorectal cancer (ACC), were treated with MTX = 200 mg/m2 iv day 1 and 5-FU 600 mg/m2 day 2 with 6-S LV 10 mg/m2 po q 6 h X 6 starting 24 h after MTX, repeated every 2 weeks. Of 30 evaluable patients, 2 Partial Remissions (PR) were achieved (Response Rate = 6.6%; 95% Confidence Interval 0%-14%). Eight patients had disease stabilization (SD). The overall median survival was 5 months (range 1-11). No WHO grade III-IV toxicities were reported. Despite the good tolerability, this combination of MTX, 5-FU and LV rescue has minimal activity in ACC after the failure of 5FU+LV-based chemotherapy.
authors.affiliation: Servizio di Oncologia, Spedali Civili, Brescia, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Zaniboni
authors.forename: R
authors.initials: R
authors.lastname: Labianca
authors.forename: G
authors.initials: G
authors.lastname: Martignoni
authors.forename: S
authors.initials: S
authors.lastname: Barni
authors.forename: M
authors.initials: M
authors.lastname: Vinci
authors.forename: M
authors.initials: M
authors.lastname: Vaghi
authors.forename: M
authors.initials: M
authors.lastname: Pirovano
authors.forename: G
authors.initials: G
authors.lastname: Facendola
authors.forename: G
authors.initials: G
authors.lastname: Marini
authors.forename: G
authors.initials: G
authors.lastname: Luporini
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D015179:Colorectal Neoplasms / Q000188:drug therapy*; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D008875:Middle Aged; D016879:Salvage Therapy
chemical_list: D002955:Leucovorin; D005472:Fluorouracil; D008727:Methotrexate