Phase II study of a weekly 24-hour infusion with 5-fluorouracil and simultaneous sodium-folinic acid in the first-line treatment of metastatic colorectal cancer
G. Hartung et al., Phase II study of a weekly 24-hour infusion with 5-fluorouracil and simultaneous sodium-folinic acid in the first-line treatment of metastatic colorectal cancer, ONKOLOGIE, 24(5), 2001, pp. 457-462
Background. A weekly continuous 24-hour infusion therapy with 5-fluorouraci
l (5-FU) and calcium - folinic acid (CA-FA) was shown to be an effective fi
rst-line treatment in advanced metastatic colorectal cancer. Sodium - folin
ic acid (S-FA) is a new formulation which, in contrast to CA-FA allows the
simultaneous Lv. administration in combination with 5-FU in one pump. Patie
nts and Methods; From 1997 to 1998, 51 patients [median age 60 (range 24-77
) years; 38 male, 13 female] with metastatic colorectal cancer were recruit
ed in 5 centers to receive weekly 24-hour infusions of 5-FU (2,600 mg/m(2))
and S-FA (500 mg/m(2)) dissolved in one pump for 6 weeks as first-line tre
atment. The treatment cycle was repeated after a 2-week rest period. Result
s: 1,178 administrations (median 24, range 3-54) were performed during the
study. Out of 51 patients (median follow-up 20.2 months), 2 (3.9%) achieved
complete remission (CR), 17 (33.3%) partial remission (PR), and 21 (41.2%)
no change (NC). Progressive disease (PD) was observed in 11/51 (21.6%) pat
ients, including 6 patients who did not complete the first cycle. Median ti
me to tumor progression (TTP) was 8.5 months (95% Cl: 5.8-11.3). 32/51 (62.
7%) patients survived for more than 1 year, the median survival was reached
at 16.5 months (95%Cl: 10.2-22.8). Among major toxicities, NCL-CTC grade I
II/IV diarrhea occurred in 13/51 25.4%), grade III hand-foot syndrome in 6/
51 (11.7% patients. Grade III/IV stomatitis was observed in 4/51 (7.8%), ca
rdiac toxicity occurred in 2/51 patients (3.9%). Conclusion: Similar to con
ventional 24-hour 5-FU + CA-FA treatment, the combination with S-FA induced
37.2% objective responses with moderate toxicity. However, TTP seems favor
able and the administration of S-FA is convenient, while saving costs and t
ime for the patient in outpatient units.