Biweekly oxaliplatin plus 1-day infusional fluorouracil/leucovorin followed by metronomic chemotherapy with tegafur/uracil in pretreated metastatic colorectal cancer.
OBJECTIVE
Metronomic chemotherapy, at a minimally toxic dose and with a frequent schedule, is a potentially novel approach to the control of advanced cancer disease via a different mechanism from maximum tolerable doses chemotherapy. Taking advantage of the potential effectiveness of metronomic therapy, tegafur/uracil (UFT) was incorporated into an oxaliplation/infusioanl fluouracil (5-FU)/leucovorin (LV) protocol in this study. The primary endpoints were response rate, time to progression (TTP) and safety profile in 5-FU-pretreated metastatic colorectal cancers (CRCs).


METHODS
Twenty-eight patients with metastatic CRCs resistant or refractory to 5-FU/LV were enrolled. Chemotherapy was administrated every 2 weeks sequentially with 2-h infusion of oxaliplatin (85 mg/m2) and LV (200 mg/m2), intravenous bolus 5-FU (400 mg/m2), 22-h infusion of 5-FU (600 mg/m2) on day 1 and then followed by 10-day daily oral UFT (200 mg/m2)/LV (30 mg/m2).


RESULTS
Partial response was seen in ten (35.7%) patients. The median TTP was 5.2 (95% CI: 4.16-6.31) months and the median overall survival was 13.4 (95% CI: 6.39-20.5) months. No grade 3 toxicities above 5% according to National Cancer Institute-Common Toxicity Criteria (NCI-CTC) occurred except sensory neuropathy (10.7%). No grade 4 toxicity, treatment-related mortality or hand-foot syndrome was found.


CONCLUSIONS
This study protocol with favorable toxicity profile is thus promisingly effective against 5-FU-pretreated metastatic CRCs. Given the present experience, an evaluation of the regimen as front-line treatment of metastatic CRC is planned.
Lin
Peng-Chan
PC
Division of Medical Oncology, Taipei Veterans General Hospital and National Yang-Ming University, No. 201, Shi-Pai Rd., Sec. 2, Taipei 112, Taiwan, ROC.
Chen
Wei-Shone
WS
Chao
Ta-Chung
TC
Yang
Shung-Haur
SH
Tiu
Chui-Mei
CM
Liu
Jin-Hwang
JH
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use* / Q000633:toxicity; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology; D004334:Drug Administration Schedule; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D007262:Infusions, Intravenous; D002955:Leucovorin / Q000008:administration & dosage; D009362:Neoplasm Metastasis; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D000077150:Oxaliplatin; D018579:Patient Selection; D016019:Survival Analysis; D005641:Tegafur / Q000008:administration & dosage; D014498:Uracil / Q000008:administration & dosage
D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D005641:Tegafur; D014498:Uracil; D002955:Leucovorin; D005472:Fluorouracil