February 2, 2006
Sequential 5-fluorouracil (5-FU) and cisplatin (CDDP) may benefit patients with metastatic colorectal cancer.
According to recent research from Japan, "a great synergy has been reported in a number of preclinical studies when 5-FU precedes cisplatin CDDP. The objective of this study was to determine the feasibility of ambulatory continuous infusion of 5-FU followed by CDDP through hepatic artery for metastatic colorectal cancer."
"Seventeen patients with unresectable liver metastases, who underwent primary tumor resection, were treated with 5-FU (450 mg/m2/day) for 7 consecutive days followed by CDDP (100 mg/body/week) for 7 consecutive days, each administered continuously by using a balloon pump via Infuse-A-Port catheter inserted into common hepatic artery," described B.L. Qin and colleagues, Kyushu University.
"The doses of drugs were reduced 20% in patients older than 70 years. The treatment was repeated every 4-6 weeks until disease progression. Of 17 assessable patients, 9 patients showed PR (53%; 95% CI, 29.3-76.7%) and 8 patients had SD (47%; 95% CI, 23.3-70.7%), with disease control rate of 100%."
Scientists reported, "the median overall survival was 26 months (95% CI: 17.5-41 months) and TTP 14 months (95% CI: 11-20.3 months). Two patients (11.8%), who showed progression due to collateral feeding arteries, responded to HAI again after occlusion. Grade 3 toxicity included leukopenia (12%) and anemia (24%). Grade 4 toxicity was absent."
"Four patients (23.5%) progressed at extrahepatic sites. This sequential combination of 5-FU followed by CDDP through hepatic artery is active and safe in an outpatient setting, and warrants further multi-institutional study, although prevention of micrometastasis would be mandatory to further prolong overall survival," researchers concluded.
Qin and colleagues published their study in Cancer Chemotherapy and Pharmacology (Feasibility study of ambulatory continuous infusion of 5-fluorouracil followed by cisplatin through hepatic artery for metastatic colorectal cancer. Cancer Chemother Pharmacol, 2006;57(1):114-119).
For additional information, contact S. Nakano, Kyushu University, Graduate School of Medicine, Dept. Internal Medicine 1, Higashi Ku, 3-1-1 Maidashi, Fukuoka 8128582, Japan.
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