A phase II study of Tomudex alternated with methotrexate, 5-fluorouracil, leucovorin in first-line chemotherapy of metastatic colorectal cancer
| Autor: | Vincenzo Catalano, Rodolfo Mattioli, Sandro Barni, Roberto Labianca, Luciano Frontini, Stefano Cascinu, G. Martignoni, Anna Maria Baldelli, L Giuliodori, R. R. Silva, Romina Agostinelli, Giuseppina Catalano, Giampietro Gasparini |
|---|---|
| Rok vydání: | 1999 |
| Předmět: |
Adult
Male medicine.medical_specialty Colorectal cancer medicine.medical_treatment Leucovorin Phases of clinical research Thiophenes Adenocarcinoma Neutropenia Gastroenterology Disease-Free Survival Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans Aged Chemotherapy Performance status business.industry Hematology Middle Aged Prognosis medicine.disease Chemotherapy regimen Surgery Survival Rate Regimen Methotrexate Treatment Outcome Oncology Fluorouracil Lymphatic Metastasis Quinazolines Female Colorectal Neoplasms business medicine.drug |
| Zdroj: | Annals of Oncology. 10:985-987 |
| ISSN: | 0923-7534 |
| DOI: | 10.1023/a:1008373817826 |
| Popis: | Summary Purpose: This multicenter phase II study was designed to assess the efficacy of the alternating schedule of tomudex with methotrexate (MTX)/5-fluorouracil (5-FU)/leucovorin (LV) in first-line chemotherapy for metastatic colorectal cancer. Patients and methods: Patients with histologically proven metastatic colorectal cancer and at least one bidimensionally measurable lesion, aged 18-70, with performance status =S 2, normal baseline biological values, and no prior chemotherapy, were selected. Treatment was tomudex 3 mg/m 2 and, after two weeks, MTX, 200 mg/m 2 by 30' infusion after hydration with 1500 ml saline solution, followed on day 2 by 5-FU, 600 mg/m 2 and leucovorin, orally, 15 mg for six times every 6 hours, beginning 24 hours after MTX. Cycles were repeated every four weeks. Tumor response assessment was performed after three cycles. Results: Thirty-four patients were enrolled in this study, of whom twenty-four had liver metastases, nine local relapse, five lymph node involvement, four lung metastases, and three peritoneal carcinomatosis. Four patients achieved objective responses (one complete and three partial), for an overall response rate of 12% (95% CI: 0%-22%). Twelve patients had stable disease and 18 progressed on therapy. Median survival for all patients was 13 months. Two patients experienced grade 3 WHO neutropenia while hepatotoxicity was reported in 13 patients (6 grade 1, 3 grade 2, 3 grade 3, 1 grade 4), suggesting that this combination could increase hepatic toxicity in comparison to tomudex or MTX/5-FU alone. Conclusions: Our results suggest that this regimen does not warrant further investigation in advanced colorectal cancer patients, at least not with this schedule and doses. |
| Databáze: | OpenAIRE |
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