ISSN:
1569-8041
Keywords:
advanced colorectal carcinoma
;
dose intensity
;
5-fluorouracil
;
FOLFOX
;
leucovorin
;
oxaliplatin
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Abstract Background:studies of bimonthly 48-hour regimens of high-doseleucovorin (LV) (FOLinic acid), 5-fluorouracil (5-FU) by continuous infusioncombined with OXaliplatin (FOLFOX) in pretreated patients with metastaticcolorectal cancer suggest that oxaliplatin dose intensity is an importantprognostic factor for response rate and progression-free survival (PFS). Tohelp define the optimal dose schedule for oxaliplatin in pretreated metastaticcolorectal cancer, we retrospectively analyzed data from three phase IIstudies using different FOLFOX regimens (FOLFOX2, 3 and 6). Patients and methods:Data on 126/161 patients were analyzed.FOLFOX2 included oxaliplatin 100 mg/m2; FOLFOX3, 85mg/m2; and FOLFOX6, 100 mg/m2 (added to a simplifiedLV–5-FU regimen), all as two-hour infusions. A total of 47 patientsreceived low dose intensity oxaliplatin (LDI: ≤85 mg/m2/2 weeks)and 79 patients high dose intensity oxaliplatin (HDI: 〉85mg/m2/2 weeks). Results:Objective responses occurred in 31 (39%) HDIpatients and 9 (19%) LDI patients (P = 0.03). Median PFS was28 weeks, with 52% of HDI patients progression free at 6 months, and26 weeks with 36% of LDI patients progression free at six months(P = 0.02). Increased oxaliplatin dose intensity was not associatedwith increased neurotoxicity or other toxicities. FOLFOX are among the mosteffective regimens for treating LV–5-FU-resistant metastatic colorectalcancer. Conclusions:This study shows that oxaliplatin doseintensification significantly improves response rate and PFS in pretreatedmetastatic disease without increasing severe toxicity.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1023/A:1026520812351
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