Literature DB >> 8355041

Phase II study of fluorouracil, leucovorin, and interferon alfa-2a in metastatic colorectal carcinoma.

J L Grem1, E Jordan, M E Robson, R A Binder, J M Hamilton, S M Steinberg, S G Arbuck, R A Beveridge, A N Kales, J A Miller.   

Abstract

PURPOSE: To test the activity of a regimen of interferon alfa-2a (IFN alpha-2a) 5 x 10(6) U/m2 subcutaneously (SC) days 1 through 7 combined with leucovorin 500 mg/m2/d intravenously (IV) over 30 minutes and fluorouracil (5-FU) 370 mg/m2/d through IV push 1 hour after leucovorin days 2 through 6 in a phase II study. PATIENTS AND METHODS: Forty-six patients with a good performance status (PS) with measurable colorectal cancer and no prior therapy for metastatic disease were entered. Cycles were repeated at 3-week intervals if toxicity had resolved. The 5-FU dose was increased by 15% if toxicity was mild, and decreased by 15% for grade 3 to 4 nonhematologic or grade 4 hematologic toxicity.
RESULTS: Three complete responses (CRs) and 21 partial responses (PRs) were seen among 44 assessable patients (54%; 95% confidence interval, 39% to 70%). A moderately strong association was noted between PS and response: PS O (n = 26), two CRs and 15 PRs (65%); PS 1 (n = 13), one CR and six PRs (54%); PS 2 (n = 5), zero CRs and zero PRs (0%; two-tailed P = .026). With a median follow-up duration of 18.8 months, the median time to treatment failure (TTF) and survival were 7.8 months and 16.3 months, respectively. Doses were escalated to 425 mg/m2/d 5-FU in 10 patients, but only four tolerated the higher dose. When expressed as the most severe degree of toxicity experienced by each patient across all cycles, grade 3 to 4 toxicity of the following types was observed; mucositis, 37%; diarrhea, 40%; rash, 7%; fatigue, 14%; granulocytopenia, 13%. Dose-limiting toxicity at 370 mg/m2/d 5-FU eventually occurred in 28 patients (61%). Twelve patients (26%) required an IFN alpha-2a dose reduction for constitutional toxicity.
CONCLUSION: This regimen has promising activity in advanced colorectal cancer, particularly in patients with an Eastern Cooperative Oncology Group (ECOG) PS of 0 to 1.

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Year:  1993        PMID: 8355041     DOI: 10.1200/JCO.1993.11.9.1737

Source DB:  PubMed          Journal:  J Clin Oncol        ISSN: 0732-183X            Impact factor:   44.544


  9 in total

Review 1.  How to optimize the effect of 5-fluorouracil modulated therapy in advanced colorectal cancer.

Authors:  P Ragnhammar; H Blomgren
Journal:  Med Oncol       Date:  1995-09       Impact factor: 3.064

2.  Increase of survival benefit in advanced resectable colon cancer by extent of adjuvant treatment: results of a randomized trial comparing modulation of 5-FU + levamisole with folinic acid or with interferon-alpha.

Authors:  Karl-Heinz Link; Marko Kornmann; Ludger Staib; Martin Redenbacher; Martina Kron; Hans Günter Beger
Journal:  Ann Surg       Date:  2005-08       Impact factor: 12.969

3.  Kinetically guided neoadjuvant chemoradiotherapy based on 5-Fluorouracil in patients with locally advanced rectal cancer.

Authors:  Jiří Grim; Miloš Hroch; Hroch Miloš; Jaroslav Chládek; Chládek Jaroslav; Jiří Petera; Petera Jiří; Jiřina Martínková; Martínková Jiřina
Journal:  Clin Pharmacokinet       Date:  2015-05       Impact factor: 6.447

4.  Genetic evidence that intratumoral T-cell proliferation and activation are associated with recurrence and survival in patients with resected colorectal liver metastases.

Authors:  Ajay V Maker; Hiromichi Ito; Qianxing Mo; Elliot Weisenberg; Li-Xuan Qin; Simon Turcotte; Shishir Maithel; Jinru Shia; Leslie Blumgart; Yuman Fong; William R Jarnagin; Ronald P DeMatteo; Michael I D'Angelica
Journal:  Cancer Immunol Res       Date:  2015-01-19       Impact factor: 11.151

Review 5.  New targets for pyrimidine antimetabolites in the treatment of solid tumours. 1: Thymidylate synthase.

Authors:  C L van der Wilt; G J Peters
Journal:  Pharm World Sci       Date:  1994-04-15

6.  A clinical and pharmacological study of 5-fluorouracil, leucovorin and interferon alfa in advanced colorectal cancer.

Authors:  M J Moore; L Kaizer; C Erlichman; R Myers; R Feld; J J Thiessen; S Fine
Journal:  Cancer Chemother Pharmacol       Date:  1995       Impact factor: 3.333

7.  A phase II and pharmacokinetic study of 6S-leucovorin plus 5-fluorouracil in patient with colorectal carcinoma.

Authors:  N J Meropol; N J Petrelli; Y M Rustum; M Rodriguez-Bigas; L E Blumenson; C Frank; E Berghorn; P J Creaven
Journal:  Invest New Drugs       Date:  1995       Impact factor: 3.850

Review 8.  Immunotherapy for liver tumors: present status and future prospects.

Authors:  Pablo Matar; Laura Alaniz; Viviana Rozados; Jorge B Aquino; Mariana Malvicini; Catalina Atorrasagasti; Manuel Gidekel; Marcelo Silva; O Graciela Scharovsky; Guillermo Mazzolini
Journal:  J Biomed Sci       Date:  2009-03-06       Impact factor: 8.410

9.  Double modulation of 5-fluorouracil with interferon alpha 2a and high-dose leucovorin: a phase I and II study.

Authors:  M T Seymour; P W Johnson; M R Hall; P F Wrigley; M L Slevin
Journal:  Br J Cancer       Date:  1994-10       Impact factor: 7.640

  9 in total

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