Chemotherapeutic strategies in metastatic colorectal cancer: an overview of current clinical trials

C H Köhne-Wömpner; H J Schmoll; A Harstrick; Y M Rustum

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Chemotherapeutic strategies in metastatic colorectal cancer: an overview of current clinical trials

Journal article

Peer reviewed

Chemotherapeutic strategies in metastatic colorectal cancer: an overview of current clinical trials

C H Köhne-Wömpner, H J Schmoll, A Harstrick and Y M Rustum

Seminars in oncology, Vol.19(2 Suppl 3), pp.105-125

04/1992

PMID: 1373004

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Abstract

5-Fluorouracil (5-FU) is still the mainstay of chemotherapy in patients with metastatic colorectal cancer. A prolonged infusion of 5-FU is more active than any other schedule of 5-FU used to date. Cisplatin does not improve treatment results compared with 5-FU alone and is not recommended outside clinical trials. Biomodulation of 5-FU is a major step forward in the treatment of colorectal cancer patients and as the standard chemotherapy for advanced colorectal cancer. Two schedules of folinic acid daily for 5-day (low and high doses) and weekly high dose in combination with daily or weekly 5-FU are the most widely used schedules. Although the response rates to either schedule are comparable, the profile of toxicity is different, being stomatitis for the daily schedule and diarrhea for the weekly schedule as the dose-limiting toxicity. Modulation of 5-FU by methotrexate is time dependent. An interval of 24 hours between methotrexate and 5-FU is necessary for effective modulation. Other modulators, like interferon and N-phosphonoactyl-L-aspartate (PALA), are promising treatment options currently under investigation in randomized trials. The data from phase II and III trials using modulation of 5-FU by folinic acid, PALA, or methotrexate, or using continuous infusion 5-FU indicate that all of these strategies are active. Randomized trials are currently underway to further investigate these therapeutic approaches and whether a specific modulation offers more therapeutic advantages.

Antimetabolites, Antineoplastic - administration & dosage

Antineoplastic Combined Chemotherapy Protocols - therapeutic use

Aspartic Acid - administration & dosage

Aspartic Acid - analogs & derivatives

Cisplatin - administration & dosage

Clinical Trials as Topic

Colorectal Neoplasms - drug therapy

Colorectal Neoplasms - mortality

Drug Administration Schedule

Fluorouracil - administration & dosage

Fluorouracil - metabolism

Fluorouracil - therapeutic use

Humans

Infusions, Intravenous

Interferons - administration & dosage

Leucovorin - administration & dosage

Methotrexate - administration & dosage

Phosphonoacetic Acid - administration & dosage

Phosphonoacetic Acid - analogs & derivatives

Details

Title: Subtitle: Chemotherapeutic strategies in metastatic colorectal cancer: an overview of current clinical trials
Creators: C H Köhne-Wömpner - Hochschule Hannover
H J Schmoll
A Harstrick
Y M Rustum
Resource Type: Journal article
Publication Details: Seminars in oncology, Vol.19(2 Suppl 3), pp.105-125
PMID: 1373004
ISSN: 0093-7754
eISSN: 1532-8708
Language: English
Date published: 04/1992
Academic Unit: Hematology, Oncology, and Blood & Marrow Transplantation; Internal Medicine
Record Identifier: 9984359903202771

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