Major innovations and clinical applications of disodium-levofolinate: a review of available preclinical and clinical data
| Autor: | Sandro Barni, Jens C. Hahne, Fausto Petrelli, Margherita Ratti, Michele Ghidini, Gianluca Tomasello, Rodolfo Passalacqua, Emanuela Alessandra Castelli, Laura Toppo |
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| Rok vydání: | 2019 |
| Předmět: |
0301 basic medicine
Oncology medicine.medical_specialty Catheter Obstruction disodium levofolinate Review lcsh:RC254-282 03 medical and health sciences 0302 clinical medicine Bolus (medicine) synergism Internal medicine Medicine Infusion pump 5-fluorouracil Levofolinate calcium-folinic acid Adverse effect business.industry solubility lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens concomitant infusion Clinical trial Catheter 030104 developmental biology 030220 oncology & carcinogenesis Catheter occlusion business |
| Zdroj: | Therapeutic Advances in Medical Oncology Therapeutic Advances in Medical Oncology, Vol 11 (2019) |
| ISSN: | 1758-8359 |
| DOI: | 10.1177/1758835919853954 |
| Popis: | The association of folinate salts with 5-fluorouracil (5-FU) represents a gold standard in the treatment of many cancers. In several clinical trials, the simultaneous administration of calcium–folinic acid (Ca-FA) and the prolonged infusion of 5-FU resulted in a better clinical response compared with fluoropyrimidine alone and 5-FU bolus. However, the simultaneous infusion of 5-FU and Ca-FA mixed in the same infusion pump is hindered by the crystallization of calcium salts, which eventually leads to catheter obstruction and damage. The sodium salt of leucovorin-disodium levofolinate (Na-Lv) is a novel molecule with a pharmacological profile similar to Ca-FA. Owing to its higher solubility, it can be safely mixed with 5-FU in a single pump without the risk of precipitation and catheter occlusion. The efficacy and safety of Na-Lv have been widely examined in preclinical and clinical phase II studies in combination with various schedules of 5-FU and in several cancer types. PubMed, EMBASE, SCOPUS and Web of Science databases were searched from inception to November 2018 to retrieve available published phase I and II series, including Western patients. Compared with Ca-FA, Na-Lv shows a more favourable efficacy and toxicity profile in terms of overall response rate, progression-free survival, time to progression and occurrence of severe adverse events. Moreover, it allows treatment time to be shortened, decreasing the number of required human resources for drug administration and limiting the occurrence of catheter damage. |
| Databáze: | OpenAIRE |
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