A phase II pilot study of high-dose 24-hour continuous infusion of 5-FU and leucovorin and low-dose PALA for patients with colorectal cancer: A Southwest Oncology Group study

Robert P. Whitehead, Jacqueline K. Benedetti, James L. Abbruzzese, Bach Ardalan, Stephen Williamson, Ellen R. Gaynor, Stanley P. Balcerzak, John S. Macdonald

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Purpose: The purpose of this phase II multi-institutional study was to define the efficacy and toxicity of infusional 5-FU in combination with PALA and leucovorin in patients with advanced colorectal cancer. Patients and methods: Patients were required to have histologically confirmed colorectal cancer with distant metastases. The treatment regimen consisted of 5-FU 2600 mg/m 2 as a 24-hours continuous infusion given once a week, concurrently with leucovorin (LV) at 500 mg/m2 as a 24-hour continuous infusion. PALA was administered 24 hours prior to 5-FU/LV at a dose of 250 mg/m 2 iv over 15 minutes weekly. Patients were continued on the assigned treatment regimen until progression of disease, unacceptable toxicity, or the patient declined further therapy. Results: This study accrued 28 patients and all were eligible and evaluable for toxicity. Four patients had inadequate assessment of response and are considered non-responders. There was one complete response and five partial responses for an overall response rate of 6/28 or 21% (95% confidence interval 8-41%). Estimated median survival was 17.4 months (95% confidence interval 13.3-20.5 months). One patient died of a treatment related infection. This patient also had grade 4 diarrhea and vomiting. Conclusion: The combination of 5-FU, leucovorin, and PALA in the doses and schedule used here, produces a response rate similar to other modulated schedules of 5-FU with similar survival and toxicity profiles.

Original languageEnglish
Pages (from-to)467-473
Number of pages7
JournalInvestigational New Drugs
Volume22
Issue number4
DOIs
StatePublished - Nov 1 2004

Fingerprint

NSC 224131
Leucovorin
Fluorouracil
Colorectal Neoplasms
Appointments and Schedules
Confidence Intervals
Survival
Therapeutics

Keywords

  • 5-FU
  • colorectal cancer
  • leucovorin
  • PALA
  • Phase II

ASJC Scopus subject areas

  • Molecular Medicine
  • Pharmacology

Cite this

A phase II pilot study of high-dose 24-hour continuous infusion of 5-FU and leucovorin and low-dose PALA for patients with colorectal cancer : A Southwest Oncology Group study. / Whitehead, Robert P.; Benedetti, Jacqueline K.; Abbruzzese, James L.; Ardalan, Bach; Williamson, Stephen; Gaynor, Ellen R.; Balcerzak, Stanley P.; Macdonald, John S.

In: Investigational New Drugs, Vol. 22, No. 4, 01.11.2004, p. 467-473.

Research output: Contribution to journalArticle

Whitehead, Robert P. ; Benedetti, Jacqueline K. ; Abbruzzese, James L. ; Ardalan, Bach ; Williamson, Stephen ; Gaynor, Ellen R. ; Balcerzak, Stanley P. ; Macdonald, John S. / A phase II pilot study of high-dose 24-hour continuous infusion of 5-FU and leucovorin and low-dose PALA for patients with colorectal cancer : A Southwest Oncology Group study. In: Investigational New Drugs. 2004 ; Vol. 22, No. 4. pp. 467-473.
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abstract = "Purpose: The purpose of this phase II multi-institutional study was to define the efficacy and toxicity of infusional 5-FU in combination with PALA and leucovorin in patients with advanced colorectal cancer. Patients and methods: Patients were required to have histologically confirmed colorectal cancer with distant metastases. The treatment regimen consisted of 5-FU 2600 mg/m 2 as a 24-hours continuous infusion given once a week, concurrently with leucovorin (LV) at 500 mg/m2 as a 24-hour continuous infusion. PALA was administered 24 hours prior to 5-FU/LV at a dose of 250 mg/m 2 iv over 15 minutes weekly. Patients were continued on the assigned treatment regimen until progression of disease, unacceptable toxicity, or the patient declined further therapy. Results: This study accrued 28 patients and all were eligible and evaluable for toxicity. Four patients had inadequate assessment of response and are considered non-responders. There was one complete response and five partial responses for an overall response rate of 6/28 or 21{\%} (95{\%} confidence interval 8-41{\%}). Estimated median survival was 17.4 months (95{\%} confidence interval 13.3-20.5 months). One patient died of a treatment related infection. This patient also had grade 4 diarrhea and vomiting. Conclusion: The combination of 5-FU, leucovorin, and PALA in the doses and schedule used here, produces a response rate similar to other modulated schedules of 5-FU with similar survival and toxicity profiles.",
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