Adjuvant chemotherapy with 5-fluorouracil, L-folinic acid and levamisole for patients with colorectal cancer: Non-randomised comparison of weekly versus four-weekly schedules — less pain, same gain

Abstract

The once-weekly regimen is much less toxic than and, apparently, about as effective as the four-weekly schedule. This suggests that the toxicity of 5-FU-L-FA adjuvant chemotherapy could be reduced substantially by weekly scheduling without compromising efficacy. Alternatively, efficacy might be enhanced with equal toxicity by more dose-intense weekly FU-L-FA regimens. However, this conclusion from a non-randomised comparison needs confirmation in prospective randomised studies.

Colorectal Cancer Screening for Average-Risk North Americans: An Economic Evaluation

“…These estimates were the average stage-based treatment costs for chemotherapy, taking into account that not all patients would be eligible for or would comply with treatment. Patients with stage IIB disease (∼50% of stage II patients) are generally managed with adjuvant chemotherapy using eight cycles of capecitabine [60],[61]. First line therapy for patients with stage III CRC was assumed to be 6 mo of oxaliplatin-based therapy [62].…”

Initiation of adjuvant chemotherapy within 8 weeks of elective colorectal resection improves overall survival regardless of reoperation

“…This may have impacted to differing degrees on overall survival, regardless of whether a delay in the delivery of adjuvant chemotherapy occurred. In the UK, regimens based on 5‐fluorouracil and folinic acid with or without levamisole (QUASAR ) were most commonly used until 2005 and thereafter regimens combined the former with oxaliplatin (MOSAIC ). Although the HES dataset does not provide information on the specific drugs given, we noted that rates of the receipt of chemotherapy, the proportion of patients receiving timely chemotherapy and the subsequent impact on overall survival were similar between the two time periods (1997–2005 and 2006–2012).…”

Cost analysis of biomarker testing for mismatch repair deficiency in node-positive colorectal cancer

“…The Quick And Simple And Reliable (QUASAR) study showed that the weekly schedule is much less toxic than, and about as effective as, the monthly Mayo Clinic regimen29. Subsequent to this, however, the Multicenter International Study of Oxaliplatin/5‐Fluorouracil/ Leucovorin in the Adjuvant Treatment of Colon Cancer (MOSAIC) trial found significantly improved disease‐free survival with the addition of oxaliplatin to 5‐FU and leucovorin (FOLFOX), although there were significantly greater reported adverse events with this regimen23.…”