The role of 5-fluorouracil (5-FU) reintroduction with irinotecan or oxaliplatin in truly 5-FU-refractory advanced colorectal cancer patients

M. Scartozzi, A. Sobrero, G. Gasparini, R. Berardi, V. Catalano, F. Graziano, S. Barni, A. Zaniboni, G. D. Beretta, R. Labianca, S. Cascinu

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: Although several evidences have demonstrated a synergistic activity of 5-fluorouracil with irinotecan and oxaliplatin, thus explaining the use of this drug combination in the first-line treatment of advanced colorectal cancer, the need for the reintroduction of 5-FU in the second-line setting is more questionable. Methods: We retrospectively evaluated the outcome of patients developing progressive disease while on an infusional 5-FU-based front-line chemotherapy and subsequently treated with one of the four following chemotherapy regimens: irinotecan, oxaliplatin and irinotecan or oxaliplatin both combined with the de Gramont schedule (LV5-FU2). Results: 225 patients (137 males and 88 females), were eligible for analysis. Second-line chemotherapy consisted of irinotecan in 79 patients (35%, group A), oxaliplatin in 47 patients (21%, group B), irinotecan with LV5-FU2 in 53 patients (24%, group C) and oxaliplatin with LV5-FU2 in the remaining 46 cases (20%, group D). The response rate to second-line chemotherapy was obtained in 6/79 patients (8%) in group A, in 4/47 patients (9%) in group B, in 11/53 patients (21%) in group C and in 10/46 patients (22%) in group D (p = 0.04). Conclusions: These data suggest that reintroduction of 5-FU could increase irinotecan and oxaliplatin activity in patients progressing during a 5-FU-based first-line chemotherapy.

Original languageEnglish
Pages (from-to)212-216
Number of pages5
JournalOncology
Volume68
Issue number2-3
DOIs
Publication statusPublished - Jul 2005

Keywords

  • 5-Fluorouracil
  • Colorectal cancer
  • Second-line chemotherapy

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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