Literature DB >> 15292717

A phase II pilot study of high-dose 24-hour continuous infusion of 5-FU and leucovorin and low-dose PALA for patients with colorectal cancer: a Southwest Oncology Group study.

Robert P Whitehead1, Jacqueline K Benedetti, James L Abbruzzese, Bach Ardalan, Stephen Williamson, Ellen R Gaynor, Stanley P Balcerzak, John S Macdonald.   

Abstract

PURPOSE: The purpose of this phase II multi-institutional study was to define the efficacy and toxicity of infusional 5-FU in combination with PALA and leucovorin in patients with advanced colorectal cancer. PATIENTS AND METHODS: Patients were required to have histologically confirmed colorectal cancer with distant metastases. The treatment regimen consisted of 5-FU 2600 mg/m(2) as a 24-hours continuous infusion given once a week, concurrently with leucovorin (LV) at 500 mg/m(2) as a 24-hour continuous infusion. PALA was administered 24 hours prior to 5-FU/LV at a dose of 250 mg/m(2) iv over 15 minutes weekly. Patients were continued on the assigned treatment regimen until progression of disease, unacceptable toxicity, or the patient declined further therapy.
RESULTS: This study accrued 28 patients and all were eligible and evaluable for toxicity. Four patients had inadequate assessment of response and are considered non-responders. There was one complete response and five partial responses for an overall response rate of 6/28 or 21% (95% confidence interval 8-41%). Estimated median survival was 17.4 months (95% confidence interval 13.3-20.5 months). One patient died of a treatment related infection. This patient also had grade 4 diarrhea and vomiting.
CONCLUSION: The combination of 5-FU, leucovorin, and PALA in the doses and schedule used here, produces a response rate similar to other modulated schedules of 5-FU with similar survival and toxicity profiles.

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Year:  2004        PMID: 15292717     DOI: 10.1023/B:DRUG.0000036689.28596.c6

Source DB:  PubMed          Journal:  Invest New Drugs        ISSN: 0167-6997            Impact factor:   3.850


  34 in total

1.  Sequential biochemical modulation of fluorouracil with folinic acid, N-phosphonacetyl-L-aspartic acid, and interferon alfa-2a in advanced colorectal cancer.

Authors:  M E Royce; W McGarry; B Bready; S R Dakhil; R J Belt; J W Goodwin; R Gray; P M Hoff; R Winn; R Pazdur
Journal:  J Clin Oncol       Date:  1999-10       Impact factor: 44.544

2.  Thymidylate synthase expression in colorectal cancer: a prognostic and predictive marker of benefit from adjuvant fluorouracil-based chemotherapy.

Authors:  David Edler; Bengt Glimelius; Marja Hallström; Anders Jakobsen; Patrick G Johnston; Inger Magnusson; Peter Ragnhammar; Henric Blomgren
Journal:  J Clin Oncol       Date:  2002-04-01       Impact factor: 44.544

Review 3.  Biochemistry and clinical activity of N-(phosphonacetyl)-L-aspartate: a review.

Authors:  J L Grem; S A King; P J O'Dwyer; B Leyland-Jones
Journal:  Cancer Res       Date:  1988-08-15       Impact factor: 12.701

4.  Effect of excess folates and deoxyinosine on the activity and site of action of 5-fluorouracil.

Authors:  R M Evans; J D Laskin; M T Hakala
Journal:  Cancer Res       Date:  1981-09       Impact factor: 12.701

5.  Efficacy of intravenous continuous infusion of fluorouracil compared with bolus administration in advanced colorectal cancer.

Authors:  P Piedbois; P Rougier; M Buyse; J Pignon; L Ryan; R Hansen; B Zee; B Weinerman; J Pater; C Leichman; J Macdonald; J Benedetti; J Lokich; J Fryer; G Brufman; R Isacson; A Laplanche; E Levy
Journal:  J Clin Oncol       Date:  1998-01       Impact factor: 44.544

6.  Phase I-phase II trial of N-phosphonacetyl-L-aspartic acid given by intravenous infusion and 5-fluorouracil given by bolus injection.

Authors:  C Erlichman; R C Donehower; J L Speyer; R Klecker; B A Chabner
Journal:  J Natl Cancer Inst       Date:  1982-02       Impact factor: 13.506

7.  Phase III randomized study of two fluorouracil combinations with either interferon alfa-2a or leucovorin for advanced colorectal cancer. Corfu-A Study Group.

Authors: 
Journal:  J Clin Oncol       Date:  1995-04       Impact factor: 44.544

8.  Biochemical determinants of responsiveness to 5-fluorouracil and its derivatives in xenografts of human colorectal adenocarcinomas in mice.

Authors:  J A Houghton; S J Maroda; J O Phillips; P J Houghton
Journal:  Cancer Res       Date:  1981-01       Impact factor: 12.701

9.  Adjuvant 5-fluorouracil and leucovorin with or without interferon alfa-2a in colon carcinoma: National Surgical Adjuvant Breast and Bowel Project protocol C-05.

Authors:  N Wolmark; J Bryant; R Smith; J Grem; C Allegra; D Hyams; J Atkins; N Dimitrov; R Oishi; D Prager; L Fehrenbacher; E Romond; L Colangelo; B Fisher
Journal:  J Natl Cancer Inst       Date:  1998-12-02       Impact factor: 13.506

10.  Modulation of 5-FU metabolism in human MCF-7 breast carcinoma cells.

Authors:  P P Major; E M Egan; L Sargent; D W Kufe
Journal:  Cancer Chemother Pharmacol       Date:  1982       Impact factor: 3.333

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