title: [Oxaliplatin, folinic acid and 5-fluorouracil (folfox) in pretreated patients with metastatic advanced cancer. The GERCOD].
abstract: Preliminary studies suggest synergy between oxaliplatin and fluorouracil (5-FU). To assess this issue, we performed a study in pretreated patients with advanced colorectal cancer (CRC) resistant to leucovorin and 5-FU. Regimen consisted of oxaliplatin day 1, 130 mg/m2 every two cycles (folfox 1) or 100 mg/m2/cycle (folfox 2) or 85 mg/m2/cycle (folfox 3) and leucovorin 500 mg/m2 as a 2-hour infusion, followed by 5-FU 22 h infusion 1.5-2 g/m2 for two consecutive days every 2 weeks. One hundred and thirteen patients have been treated. One complete response (CR) and 32 partial responses (PRs) were observed for an overall response rate of 29.2%. Sixty-seven patients had prior documented progression while receiving the same schedule of leucovorin and 5-FU than the one used in the folfox regimens, among them 18 had PRs (26.9%). The best response rate was observed in patients treated with the folfox 2 regimen: 41.7%. From start of folfox, median progression-free survival was 6 months and median survival 13 months. Limiting toxicities were peripheral neuropathy and neutropenia. Fifty-four percent of the patients experienced WHO toxicity > or = grade 3 with the folfox1 regimen, 45% with the folfox2 and 40% with the folfox3. The folfox regimens achieve a high response rate in pretreated patients with CRC. Further studies are needed to determine the best oxaliplatin dose-intensity.
authors.affiliation: Service de médecine interne-oncologie, hôpital Saint-Antoine, Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: de Gramont
authors.forename: C
authors.initials: C
authors.lastname: Tournigand
authors.forename: C
authors.initials: C
authors.lastname: Louvet
authors.forename: T
authors.initials: T
authors.lastname: André
authors.forename: J L
authors.initials: JL
authors.lastname: Molitor
authors.forename: E
authors.initials: E
authors.lastname: Raymond
authors.forename: S
authors.initials: S
authors.lastname: Moreau
authors.forename: J
authors.initials: J
authors.lastname: Vignoud
authors.forename: N
authors.initials: N
authors.lastname: Le Bail
authors.forename: M
authors.initials: M
authors.lastname: Krulik
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D000077150:Oxaliplatin
chemical_list: D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D002955:Leucovorin; D005472:Fluorouracil
vernacular_title: Oxaliplatine, acide folinique et 5-fluorouracile (folfox) en seconde ligne thérapeutique du cancer colorectal métastasé. Le GERCOD.