INEFFECTIVENESS OF SEQUENTIAL HIGH-DOSE METHOTREXATE AND 5-FLUOROURACIL COMBINED WITH EPIRUBICIN (FEMTX REGIMEN) AS A SALVAGE THERAPY IN ADVANCED COLORECTAL CANCERS AND OTHER GASTROINTESTINAL TUMORS

The combination of sequential high dose methotrexate and 5-flourouraci l (FU) combined with epirubicin (FEMTX regimen) has shown some clinica l efficiency as a first line therapy in advanced gastric cancer. We ev aluated the therapeutic activity of this combination in advanced color ectal cancer patients who failed the FU + folinic acid regimen, and in advanced gastrointestinal cancer situation where no standard regimen is available. Twelve patients with measurable metastatic colorectal ca ncer refractory to first line (n = 6) or second line (n = 6) chemother apy, as well as 9 patients with advanced gastrointestinal cancer, ente red this pragmatic pilot study. Eighty-six per cent and 38% of the pat ients experienced severe haematological or non-haematological toxiciti es, respectively. Four patients were not evaluable for response due to their early departure from the scheme due to acute toxic events (n = 3) or toxic death (n = 1). No objective response was observed, but 9 s tabilisations and 8 progressive diseases were noted. The FEMTX regimen is not of clinical value as a salvage therapy in colorectal and gastr ointestinal cancer, because of its toxicity and its lack of efficacy.