Multicentre phase II study of leucovorin plus pharmacokinetic modulating chemotherapy for metastatic colorectal cancer

Abstract

Abstract. The optimal administration of 5-fluorouracil (5-FU)/leucovorin (LV) for colorectal cancer (CRC) has yet to be fully defined although evidence of the combination has already been established. In a multicentre phase II study, pharmacokinetic modulating chemotherapy (PMC), which is based on the concept that continuous intravenous 5-FU infusion can be enhanced by low-dose oral uracil/tegafur, was combined with LV and administered. Thirty-seven patients were enrolled. The objective response rate was 31.4% and the tumour stabilization rate was 85.7%. The most common toxic effects were neutropenia and hand-foot skin reactions although no life-threatening grade 3-4 toxicities were noted. Grade 3 toxicities such as neutropenia, nausea, diarrhoea and oesophagitis occurred in one patient each. We identified the usefulness of a new type of infusional 5-FU combined with LV for the treatment of CRC. The combination of PMC and LV is active with an acceptable rate of toxicity as a first-line treatment of advanced CRC.

Advances and directions in chemotherapy using implantable port systems for colorectal cancer: a historical review

“…In particular, recent reports suggested that the pharmacokinetics of 5-FU remain an important factor that affects the prognosis of patients with CRC, even after the introduction of modern chemotherapy for CRC [74–77]. An implantable port system is indispensable in both HAI and central venous port systems to optimize the pharmacokinetics in multiagent chemotherapy.…”

“…Even in modern chemotherapy using several active agents, 5-FU plays a central role in the treatment of CRC, and many attempts have been made to improve its efficacy and potentiate its action over the last 50 years. In particular, recent reports suggested that the pharmacokinetics of 5-FU remain an important factor that affects the prognosis of patients with CRC, even after the introduction of modern chemotherapy for CRC [ 74 – 77 ]. An implantable port system is indispensable in both HAI and central venous port systems to optimize the pharmacokinetics in multiagent chemotherapy.…”