Bolus and infusional 5-fluorouracil combined with cisplatin in advanced gastric cancer

5-Fluorouracil (5-FU) is the main drug used in the treatment of advanced ga stric cancer. Combination chemotherapy is not always superior to 5-FU alone , expecially when biomodulators are also administered. In an attempt to exp loit all the cytotoxic mechanisms of 5-FU, we carried out a pilot study wit h a double route of administration of 5-FU (intravenous bolus and continuou s infusion) and a multiple modulation of 5-FU by methotrexate (MTX), GS-leu covorin (GS-LV) and cisplatin (CDDP). A group of 30 patients affected by ad vanced gastric cancer was treated with MTX 50 mg/m(2) and 5-FU 400 mg/m(2) as an i.v. bolus on day 1, followed by a 5 day i.v. continuous infusion of 5-FU 600 mg/m(2)/day and 6S-LV 100 mg/m(2)/day; on day 3 CDDP 100 mg/m(2) w as also administered. The regimen was repeated every 4 weeks. Six partial r esponses (20+/-14.3%), 12 stable diseases (40+/-17.5%) and 12 progression ( 40+/-17.5%) were observed in an intent-to-treat analysis. Median survival w as 7 months. All responding patients had performance status 0-1. Grade 3-4 toxicity was mainly gastrointestinal, but grade 3-4 anemia and leucopenia w ere also recordered. The schedule has low activity. The use of different mo dulators and way of administration of 5-FU does not provide advantages in a dvanced gastric cancer.