Zusammenfassung
Das pharmakokinetische Verhalten von 5-Fluorouracil (5-FU) wurde nach alleiniger Bolusgabe und in Kombination mit Interferon alpha 2b (IFN) geprüft. 13 Patienten mit fortgeschrittenem kolorektalen Karzinom erhielten eine i.v. Bolusinjektion von 5-FU 750 mg/m2 und IFN 5 Millionen Einheiten (MU) 3mal wöchentlich subkutan. 5-FU-Plasmaspiegel wurden mittels HPLC über einen Zeitraum von 1 Stunde am Tag 1 vor Interferongabe sowie in der 2. oder 3. Behandlungswoche jeweils 1 Stunde nach der letzten Interferoninjektion bestimmt. Dabei zeigten die Pharmakokinetikparameter von 5-FU unter dem Einfluß von IFN eine signifikante Änderung, indem die fiktive Initialkonzentration (C0) um 60% sowie die Fläche unter der Kurve (AUC) um 56% anstieg und die totale Plasmaclearance (Cltot) um 55% reduziert wurde. Diese Daten liefern eine teilweise Erklärung für den für die Kombination IFN und 5-FU postulierten Synergismus, sowohl hinsichtlich erhöhter therapeutischer Wirkung wie auch verstärkter Toxizität.
Summary
The pharmacokinetic behaviour of 5-fluorouracil (5-FU) was investigated after bolus injection alone and combined with interferon alpha 2b (IFN). 13 patients suffering from advanced colorectal carcinoma were treated by weekly intravenous bolus injection of 750 mg/m2 5-FU and 5 MU IFN 3 times a week subcutaneously. 5-FU plasma levels were determined by HPLC over a time period of one hour on day 1 prior to the first application of IFN and on day 8 or 15 one hour after the last IFN injection respectively. The pharmacokinetic parameters of 5-FU were significantly influenced by IFN: the hypothetical drug concentration at time 0 (C0) was increased by 60%, the area under the curve (AUC) was increased by 56%, and the total plasma clearance (Cltot) was reduced by 55%. These data partly explain the synergistic effect of the 5-FU/IFN combination in clinical trials.
Literatur
Erlichmann C, Fine S, Wong A, et al.: A randomized trial of fluorouracil and folinic acid in patients with metastatic colorectal carcenoma. J Clin Oncol 1988;6:469–475.
Petrelli N, Douglass HO, Herrera L, et al: The modulation of fluorouracil with leucovorin in metastatic colorectal carcinoma: a prospetive randomized phase III trial. J Clin Oncol 1989:1419~1426.
Wadler S, Schwartz EL: Antineoplastic Activity of the Combination of Interferon and Cytotoxic Agents against Experimental and Human Malignancies. J Cancer Res 1990;50:3473–3486.
Wadler S, Wiernik PH: Clinical update on the role of Fluorouracil and recombinant Interferon alfa 2a in the treatment of colorectal carcinoma. Sem Oncol 1990;27 (Suppl 1): 16–21.
Pazdur R, Ajani JA, Patt YZ, et al.: Phase II study of fluorouracil and recombinant interferon alfa-2a in previously untreated advanced colorectal carcinoma. J Clin Oncol 1990;8:2027–2031.
Lindley C. Bernard S, Gavigan M. et al.: Interferon-alpha increases 5-Fluorouracil (5FU) plasma levels 64-fold within ohne hour: Results of a phase I Study. J Interferon Res No 1990 (Suppl): 116~131.
Elias L, Crissman HA: Interferon effects on the adenocarcinoma 38 and HL-60 cell lines: Antiproliferative responses and synergistic interactions with halogenated pyrimidine antimetabolites. Cancer Res 1988;48:4868–4873.
Jäger W, Czejka MJ, Schüller J, et al: Rapid and simple high-performance liquid chromatographic assay for 5-fluorouracil in plasma for bioavailability studies. J Chromatography 1990;532:411–417.
Remick SC, Grem JL, Fischer PH, et al: Phase I trial of 5-Fluorouracil and dipyridamole administered by seventy-two-hour concurrent continuous infusion. Cuncer Res 1990;50:2667–2672.
Kemeny N, Kelsen D, Derby S. et al: Combination 5-Fluorouracil (FU) and recombinant alphainterferon (Ifn) in advanced colorectal carcinoma: Activity but significant toxicity. Proc. ASCO 1990:9.
Bocci V: Renal catabolism of interferons, interleukins 1 and 2 and tumor necrosis factor. Contr Nephrol Kid Prot Health Dis 1988;68:53–57.
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Schüller, J., Czejka, M.J., Armbruster, C. et al. Pharmakokinetische Aspekte der Biomodulation von 5-Fluorouracil durch Interferon alpha 2b in der Behandlung des fortgeschrittenen kolorektalen Karzinoms. Acta Chir Austriaca 23, 214–217 (1991). https://doi.org/10.1007/BF02663228
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DOI: https://doi.org/10.1007/BF02663228