title: Double modulation with methotrexate and L-leucovorin of weekly 24- hour fluorouracil infusion in fluorouracil-refractory colorectal cancer.
abstract: No effective second-line therapy has been developed for patients with metastatic colorectal cancer progressive after than fluorouracil(FU)-containing chemotherapy. Encouraging results have been reported with weekly 24-hour FU infusion. The aim of this study was to test the activity of weekly FU infusion plus modulation with methotrexate and L-leucovorin in pretreated colorectal cancer patients. Seventeen patients with metastatic colorectal carcinoma were treated with methotrexate (40 mg/m2 on day 1), L-leucovorin (100 mg/m2 as a 4-hour infusion on day 2), and FU (2,600 mg/m2 as a 24-hour infusion on day 2). All patients had measurable disease and a performance status of ECOG O-2. Two of the 17 evaluable patients achieved partial remission (12%; 95% confidence interval 2-24%), 9 had stable disease, and 6 progressive disease. Median time to progression was 4 months (range, 2-8) and median survival was 7 months (range, 3-12+). Toxicity was generally mild or moderate and consisted of mucositis, diarrhea and neutropenia. Pretreated patients with metastatic colorectal, carcinoma benefit only marginally from this treatment schedule.
authors.affiliation: Division of Medical Oncology, City Hospital, Castelfranco Veneto, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Colleoni
authors.forename: P
authors.initials: P
authors.lastname: Nelli
authors.forename: G
authors.initials: G
authors.lastname: Vicario
authors.forename: F
authors.initials: F
authors.lastname: Pancheri
authors.forename: G
authors.initials: G
authors.lastname: Sgarbossa
authors.forename: P
authors.initials: P
authors.lastname: Manente
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002405:Catheterization, Central Venous; D003110:Colonic Neoplasms / Q000188:drug therapy*; D004334:Drug Administration Schedule; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D008875:Middle Aged; D012004:Rectal Neoplasms / Q000188:drug therapy*
chemical_list: D002955:Leucovorin; D005472:Fluorouracil; D008727:Methotrexate