Efficacy of intravenous continuous infusion of fluorouracil compared with bolus administration in advanced colorectal cancer. Meta-analysis Group In Cancer.

Piedbois, Pascal; Rougier, Philippe; Buyse, Marc; Pignon, Jean-Pierre; Ryan, L; Hansen, Richard M.; Zee, B.; Weinerman, Brian; Pater, Joe; Leichman, Cynthia G.; Macdonald, John S.; Benedetti, Jacqueline; Lokich, Jacob J.; Fryer, J. G.; Brufman, G; Isacson, Rut; Laplanche, Agnès; Levy, Estrella Mariel

doi:10.1200/jco.1998.16.1.301

Cited by 855 publications

(81 citation statements)

References 14 publications

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“…Besides higher response rates, this combination also showed an improved survival in a meta-analysis [24]. Recently, a meta-analysis showed a significantly higher response rate when 5FU was administered as a continuous infusion in patients with colorectal cancer compared to 5FU bolus injection (23 vs. 14%, respectively) [25]. …”

Section: Ts As a Target For Treatmentmentioning

confidence: 99%

Thymidylate Synthase: A Target for Combination Therapy and Determinant of Chemotherapeutic Response in Colorectal Cancer

Triest

Peters²

1999

Oncology

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In this review, we describe the role of thymidylate synthase (TS) as a determinant of chemotherapeutic response. TS is an essential enzyme for the de novo synthesis of thymidylate and subsequent DNA synthesis. TS has been used as a target for cancer chemotherapy in the development of fluoropyrimidines such as 5-fluorouracil (5FU) and 5-fluorodeoxyuridine and novel folate-based TS inhibitors such as ZD1694 (Tomudex, Raltitrexed), LY231514, AG337 (Thymitaq) and GW1843U89. All these antifolates have different transport mechanisms and various polyglutamylation and accumulation patterns which are all important for drug sensitivity. An update of clinical studies with TS inhibitors (antifolate-based TS inhibitors and 5FU combination studies) will be given and new perspectives for clinical development will be discussed. The prognostic or predictive value of TS (in vitro, in vivo and in patients) will be reviewed, focusing on colorectal cancer.

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Section: Ts As a Target For Treatmentmentioning

confidence: 99%

Thymidylate Synthase: A Target for Combination Therapy and Determinant of Chemotherapeutic Response in Colorectal Cancer

Triest

Peters²

1999

Oncology

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“…The earlier mentioned study of Lorenz and Müller [30]supports this approach. Furthermore, in systemic treatment, chemical biomodulation of 5-FU by leucovorin resulted in significantly higher response rates [18]. Hepatic arterial leucovorin administration showed only a slight regional advantage, induced catheter thrombosis, and increased the risk of biliary sclerosis when combined with FUDR [40, 41]; consequently, intravenous leucovorin is the preferred route of administration.…”

Section: Results and Complications Of Hacmentioning

confidence: 99%

“…Furthermore, FUDR and 5-FU are cell-cycle-dependent drugs and a larger number of tumor cells in the S phase will be exposed to the drug by prolonged exposure. For systemic treatment, a meta-analysis of randomized trials found continuous infusion to be superior to bolus 5-FU in terms of response and survival [18]. In HAC, continuous infusion of FUDR and 5-FU is being used in most studies.…”

Section: Theoretical and Practical Aspectsmentioning

confidence: 99%

Hepatic Arterial Chemotherapy for Colorectal Cancer Metastatic to the Liver

et al. 2000

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In advanced colorectal cancer, liver metastases are a major problem. In patients with liver metastases as the major site of disease hepatic arterial chemotherapy is a valid alternative to systemic treatment. In this review about hepatic arterial chemotherapy we will discuss the theoretical and practical aspects, the results and complications, the selection of patients for hepatic arterial chemotherapy, and its future developments.

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“…Early clinical trials confirmed the importance of constant exposure to 5-FU to obtain a therapeutic effect [3]. Protracted infusions appear to improve response and survival compared with bolus administration [4, 5]and the administration of 5-FU over prolonged periods of time may also be associated with reduced toxicity [4, 6]. The toxicity profile of 5-FU is schedule dependent.…”

Section: Introductionmentioning

confidence: 99%

Fluoropyrimidines: A Critical Evaluation

et al. 1999

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After nearly four decades of clinical experience with the fluoropyrimidines, 5-fluorouracil (5-FU) remains an integral part of chemotherapy for colorectal cancer. A range of 5-FU treatment regimens with or without biochemical modulation are currently used and toxicity appears to be schedule dependent. The use of oral 5-FU was abandoned because of erratic absorption caused by varying levels of dihydropyrimidine dehydrogenase (DPD) found in the gastrointestinal tract. This effect may be overcome by administering agents that are converted to 5-FU or by inhibiting or inactivating DPD. Xeloda^® (capecitabine) was designed as an orally administered, selectively tumoractivated^TM cytotoxic agent which achieves higher levels of 5-FU in the primary tumor than in plasma or other tissues. The United States Food and Drug Administration (FDA) has approved Xeloda for use in patients with metastatic breast cancer resistant to paclitaxel and in whom further anthracycline therapy is contraindicated. Xeloda is also registered in Canada, Switzerland, Thailand and Argentina. In phase II clinical trials in colorectal cancer, Xeloda produced response rates of 21–24% and median time to disease progression of 127–230 days. Other oral agents in development for the treatment of colorectal cancer include tegafur/uracil plus oral leucovorin, S-1 and eniluracil plus oral 5-FU.

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Efficacy of intravenous continuous infusion of fluorouracil compared with bolus administration in advanced colorectal cancer. Meta-analysis Group In Cancer.

Abstract: 5-FU CI is superior to 5-FU bolus in terms of tumor response and achieves a slight increase of overall survival. The hematologic toxicity is much less important in patients who receive 5-FU CI, but hand-foot syndrome is frequent in this group of patients.

Cited by 855 publications

References 14 publications

Thymidylate Synthase: A Target for Combination Therapy and Determinant of Chemotherapeutic Response in Colorectal Cancer

Thymidylate Synthase: A Target for Combination Therapy and Determinant of Chemotherapeutic Response in Colorectal Cancer

Hepatic Arterial Chemotherapy for Colorectal Cancer Metastatic to the Liver

Fluoropyrimidines: A Critical Evaluation

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