Treatment of advanced colorectal cancer with high-dose intensity folinic acid and 5-fluorouracil plus supportive care

Petrioli, Roberto; Lorenzi, Marco; Aquino, Angelo; Marsili, Stefania; Frediani, Bruno; Palazzuoli, V.; Marzocca, G.; Botta, Giuseppe; Tani, Francesco; Martino, Antonio; Testi, W; Setacci, Carlo; Salvestrini, Francesco; Sando, D. De; Bovenga, S; Mariani, L; Mancini, Sergio; Tanzini, G.; Armenio, S; Marinello, Enrico; Francini, Guido

doi:10.1016/0959-8049(95)00488-2

Cited by 20 publications

(10 citation statements)

References 15 publications

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“…This suggests that the CR rate is more related to the biological characteristics of the tumour than the chemotherapy dose. We have obtained similar CR rates in previous clinical trials using the simple schedule of folinic acid and 5-fluorouracil (Francini et al, 1988;Petrioli et al, 1995).…”

supporting

confidence: 65%

Reply: UFT/leucovorin and oxaliplatin alternated with UFT/leucovorin and irinotecan in metastatic colorectal cancer

Francini

Petrioli

2004

Br J Cancer

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supporting

confidence: 65%

Reply: UFT/leucovorin and oxaliplatin alternated with UFT/leucovorin and irinotecan in metastatic colorectal cancer

Francini

Petrioli

2004

Br J Cancer

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“…In recent years, enormous efforts have gone into improving its efficacy, including biochemical modulation and changing the method of its administration. The biomodulation of 5-FU by leucovorin (LV) has been shown to significantly improve response rates and prolong survival with high-and low-dose LV schedules (Bobbio-Pallavicini et al, 1993;Petrioli et al, 1995;Borner et al, 1998). Administration of 5-FU via continuous infusion has resulted in significantly better response rates when compared with bolus intravenous (i.v.)…”

mentioning

confidence: 99%

Phase II study of UFT with leucovorin and irinotecan (TEGAFIRI): first-line therapy for metastatic colorectal cancer

et al. 2007

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This phase II trial was performed to evaluate the efficacy and tolerability of oral tegafur -uracil (UFT s ) with leucovorin (LV) combined with intravenous (i.v.) irinotecan every 3 weeks (TEGAFIRI) as first-line treatment for patients with metastatic colorectal cancer (mCRC). Patients received oral UFT 250 mg m À2 day À1 and LV 90 mg day À1 in three divided daily doses for 14 days followed by a 1-week rest and i.v. irinotecan 250 mg m À2 as a 90-min infusion every 3 weeks. Tumour responses, assessed every two cycles using RECIST criteria, were reviewed by an independent review committee. In 52 evaluable patients, the best overall response rate was 33% (95% confidence intervals (CI) 20 -47%; 1 complete and 16 partial responses). The median time to progression was 5.4 months (95% CI 3.02 -7.52 months) and median overall survival was 14.9 months (11.73 -17.97 months). A total of 307 cycles were administered, with a median number of five cycles per patient (range: 1 -10). The most common grade 3/4 toxicities were neutropenia (25% of patients), diarrhoea (22%), vomiting (11%) and anaemia (11%). The TEGAFIRI regimen is a feasible, welltolerated and convenient treatment option for patients with non-resectable mCRC.

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“…They can be divided into two groups, one evaluating the weekly regimen and the other the daily-times-ve combination. A signi cant advantage in terms of objective responses was observed for uorouracil plus leucovorin in 11 out of the 16 studies (84,109,113,(117)(118)(119)(120)(121)(122)(123)(124), while the activity was similar to that of uorouracil alone in the remaining ve trials (110, 125 -128). In six studies (84,113,(121)(122)(123)(124), a prolongation of survival for the combination regimen was reported.…”

Section: Fluorouracil In Combination With Leuco×orinmentioning

confidence: 92%

“…On the basis of these results, at least 16 randomised trials comparing uorouracil plus leucovorin to uorouracil alone were performed and published in 1992-1995 (84,109,110,113,(117)(118)(119)(120)(121)(122)(123)(124)(125)(126)(127)(128). They can be divided into two groups, one evaluating the weekly regimen and the other the daily-times-ve combination.…”

Section: Fluorouracil In Combination With Leuco×orinmentioning

confidence: 99%

A Systematic Overview of Chemotherapy Effects in Colorectal Cancer

Ragnhammar¹

2001

Acta Oncologica

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A systematic review of chemotherapy trials in several tumour types was performed by The Swedish Council of Technology Assessment in Health Care (SBU). The procedures for the evaluation of the scienti c literature are described separately (Acta Oncol 2001; 40: 155 -65). This synthesis of the literature on adjuvant and palliative therapy with cytostatics for colorectal cancer is based on 208 scienti c articles, including eight meta-analyses and 162 randomised studies. These studies involve approximately 126 800 patients. The conclusions reached can be summarized into the following points:The bene t of postoperative adjuvant chemotherapy with uorouracil and levamisole in patients with colon cancer stage Dukes' C was demonstrated more than ten years ago in two phase III trials. There was a reduction of recurrence from 56% to 39% and reduction of death from 51% to 40% after more than ve years of follow-up. Although this combination has been widely accepted as standard adjuvant treatments for stage Dukes' C colon cancer, there is still debate on whether adjuvant treatment with uorouracil alone would be equally ef cacious. Several phase III trials with postoperative adjuvant chemotherapy with uorouracil and leucovorin in patients with colon cancer stage Dukes' C have demonstrated a similar statistically signi cant improvement in disease-free and overall survival in comparison with a control arm. Six months of treatment with uorouracil and leucovorin is as ef cient as twelve months of uorouracil and levamisole. This treatment is, thus, recommended for routine use. No convincing bene t from adjuvant chemotherapy is proven in colon cancer stage Dukes' B although some randomised trials have shown the same relative survival gain as seen in stage Dukes' C. There is less knowledge on survival bene ts from adjuvant chemotherapy for Dukes' stage B and C rectal cancer. In small randomised trials, postoperative radiochemotherapy has, however, improved survival to the same extent as chemotherapy in colon cancer Dukes' stage C. A meta-analysis of nine randomised trials revealed a small but statistically signi cant bene t in ve-year survival and a reduction in the risk of death for the patients receiving immediate postoperative portal vein infusion compared with controls. At present, however, the use of portal vein infusion or intraperitoneal therapy outside of a research trial cannot be recommended in the light of the limited effects. This conclusion is further supported by similarly limited effects in two recently reported very large European multicentre trials. In advanced colorectal cancer, chemotherapy may prolong survival, decrease tumour-related symptoms, improve general well-being or maintain it at a high level for a longer time period compared with best supportive care. These effects have been seen using systemic chemotherapy and using regional chemotherapy in patients with metastases limited to the liver. Subjective responses and quality of life improvements are seen more frequently than objective tumour remissions. Altho...

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Treatment of advanced colorectal cancer with high-dose intensity folinic acid and 5-fluorouracil plus supportive care

Cited by 20 publications

References 15 publications

Reply: UFT/leucovorin and oxaliplatin alternated with UFT/leucovorin and irinotecan in metastatic colorectal cancer

Reply: UFT/leucovorin and oxaliplatin alternated with UFT/leucovorin and irinotecan in metastatic colorectal cancer

Phase II study of UFT with leucovorin and irinotecan (TEGAFIRI): first-line therapy for metastatic colorectal cancer

A Systematic Overview of Chemotherapy Effects in Colorectal Cancer

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