Advertisement

5-Fluorouracil and Folinic Acid: Summary of Clinical Experience

  • Patrick J. Creaven
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 131)

Abstract

In summarizing the clinical experience with 5-fluorouracil (FU) and folinic acid (FA) I shall approach it in the context of some critical questions which may be used to determine where we currently stand and where information still needs to be sought with respect to the clinical activity of this modulation. These questions are listed in Table 1.

Keywords

International Symposium Cancer Chemotherapy Folinic Acid Advanced Colorectal Cancer Roswell Park Memorial Institute 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    R.B. Livingston and S.K. Carter, “Single Agents in Cancer Chemotherapy”, IFI/Plenum, New York, 1970, pp. 202–206.CrossRefGoogle Scholar
  2. 2.
    H. Bruckner, J. Roboz, M. Spiegelman, et al. An efficient leucovorin and 5-fluorouracil sequence: dosage escalation and pharmacological monitoring. Proc Am Assoc Cancer Res 24: 547 (1983).Google Scholar
  3. 3.
    D. Machover, E. Goldschimidt, P. Chollet, et al. Treatment of advanced colorectal and gastric adenocarcinoma with 5-fluorouracil and high-dose folinic acid. J Clin Oncol 4: 685 (1986).PubMedGoogle Scholar
  4. 4.
    P. Byrne, J. Treat, M. McFadden, et al. Therapeutic efficacy of the combination of 5-fluorouracil and high-dose leucovorin in patients with advanced colorectal carcinoma: single daily intravenous dose for five days, in: “The Current Status of 5-Fluorouracil-Leucovorin Combination,” H.W. Brucker and Y.M. Rustum, eds., Park Row Publishers, Inc., New York, 1984.Google Scholar
  5. 5.
    G.T. Budd, T. Fleming, J.D. Bukowski, et al. 5-Fluorouracil and folinic acid in the treatment of metastatic colorectal cancer: a randomized comparison. A Southwest Oncology Group Study. J Clin Oncol 5: 272 (1987).PubMedGoogle Scholar
  6. 6.
    J.H. Doroshow; M. Bertrand, P. Multhauf, et al. Prospective randomized trial comparing 5-FU versus (vs) 5-FU and high dose folinic acid (HDFA) for treatment of advanced colorectal cancer. Proc Am Soc Clin Oncol 6: 96 (1987)Google Scholar
  7. 7.
    S. Madajewicz, N.J. Petrelli, Y. Rustum, et al. A phase I trial of high dose calcium leucovorin and 5-fluorouracil in advanced colorectal cancer. Cancer Res 44: 4667 (1984).PubMedGoogle Scholar
  8. 8.
    N.J. Petrelli, Y.M. Rustum, H. Bruckner, et al. The Roswell Park Memorial Institute and Gastrointestinal Tumor Study Group phase III experience with the modulation of 5-fluorouracil by leucovorin in metastatic colorectal adenocarcinoma. in: “International Symposium on the Expanding Role of Folates and Fluoropyrimidines in Cancer Chemotherapy,” Y. Rustum and J. McGuire, eds., Plenum Press, New York, 1988, pp.Google Scholar
  9. 9.
    J.D. Hines, D.J. Adelstein, J.L. Spiess, et al. High-dose weekly oral leucovorin and 5-fluorouracil in previously untreated patients with advanced colorectal carcinoma: a phase I study. in: “International Symposium on the Expanding Role of Folates and Fluoropyrimidines in Cancer Chemotherapy,” Y. Rustum and J. McGuire, eds., Plenum Press, New York, 1988, pp.Google Scholar
  10. 10.
    J. Cunningham, R.M. Bukowski, G.T. Budd, et al. Fluorouracil and folinic acid: a phase I-II trial in gastrointestinal malignancy. Invest New Drugs 2: 391 (1984).PubMedCrossRefGoogle Scholar
  11. 11.
    J. Mortimer and C. Higano. Continuous infusion 5-fluorouracil (FU) and folinic acid (FA) in disseminated colorectal cancer: a phase I-II study. Proc. Am. A. Cancer Res. 26: 171 (1985).Google Scholar
  12. 12.
    H. Greene, A. Desai, S. Levick, et al. Combined 5-fluorouracil infusion and high dose folinic acid in the treatment of metastatic gastrointestinal cancer. Proc Am Soc Clin Oncol 5: 89 (1986).Google Scholar
  13. 13.
    H.-J. Schmoll and S. Blanc, Sequential high dose folinic acid (FA) and 5-fluorouracil (5-FU) in advanced colorectal cancer with measurable, progressive disease. Proc Am Soc Clin Oncol 4: 94 (1985).Google Scholar
  14. 14.
    H. Wilke, H.-J. Schmoll, P. Preusser, et al. Folinic acid (CF)/5-fluorouracil (FUra) combinations in advanced gastrointestinal carcinomas. in: “International Symposium on the Expanding Role of Folates and Fluoropyrimidines in Cancer Chemotherapy,” Y. Rustum and J. McGuire, eds., Plenum Press, New York, 1988, pp.Google Scholar
  15. 15.
    E.H. Valone, T. Drakes, M. Flam, et al. A Northern California Oncology Group randomized trial of single agent 5-FU vs high-dose folinic acid + 5-FU vs methotrexate + 5-FU + folinic acid in patients with disseminated measurable large bowel cancer. Abst. of The Expanding Role of Folates and Fluoropyrimidines in Cancer Chemotherapy. April 1988. Buffalo. New York.Google Scholar
  16. 16.
    L.R. Laufman, W.D. Breckman, K.A. Stydnicki, et al. Clinical experience with CF-FUra. in: “International Symposium on the Expanding Role of Folates and Fluoropyrimidines in Cancer Chemotherapy.” Y. Rustum and J. McGuire, eds., Plenum Press. New York, 1988. pp.Google Scholar
  17. 17.
    L. Canobbio, M.T. Nobile, A. Sobrero, et al. A randomized trial of 5-fluorouracil alone versus 5-fluorouracil and high dose leucovorin (LV) in untreated advanced colorectal cancer patients. in: “International Symposium on the Expanding Role of Folates and Fluoropyrimidines in Cancer Chemotherapy.” Y. Rustum and J. McGuire. eds.. Plenum Press, New York. 1988. pp.Google Scholar
  18. 18.
    N. Petrelli, D. Stablein, H. Bruckner, et al. A prospective randomized phase III trial of 5-fluorouracil (5FU) versus 5FU + high dose leucovorin (HDCF) versus 5FU + low dose leucovorin (LDCF) in patients (pts) with metastatic colorectal adenocarcinoma. A report of the Gastrointestinal Tumor Study Group. Proc Am Soc Clin Oncol 7: 94 (1988).Google Scholar
  19. 19.
    C. Erlichman, Fluorouracil (FUra) and folinic acid (FA) therapy in patients with colorectal cancer. in: “International Symposium on the Expanding Role of Folates andoropyrimidines in Cancer Chemotherapy,” Y. Rustum and J. McGuire, eds., Plenum Press, New York, 1988. pp.Google Scholar
  20. 20.
    M.J. O’Connell. A controlled clinical trial including folinic acid at two distinct dose levels in combination with 5-fluorouracil (5FU) for the treatment of advanced colorectal cancer: experience of the Mayo Clinic and North Central Cancer Treatment Group. in: “International Symposium on the Expanding Role of Folates and Fluoropyrimidines in Cancer Chemotherapy,” Y. Rustum and J. McGuire, eds., Plenum Press, New York, 1988, pp.Google Scholar
  21. 21.
    N. Petrelli, L. Herrera, Y. Rustum, et al. A prospective randomized trial of 5-fluorouracil versus 5-fluorouracil and high-dose leucovorin versus 5-fluorouracil and methotrexate in previously untreated patients with advanced colorectal carcinoma. J Clin Oncol 5: 1559 (1987).PubMedGoogle Scholar
  22. 22.
    F.H. Valone, P.S. Wittlinger. M.S. Flam, et al. A Northern California Oncology Group randomized trial of single agent 5-FU vs. high-dose folinic acid + 5-FU vs. methotrexate + 5-FU + folinic acid in patients with disseminated measurable large bowel cancer. in: “International Symposium on the Expanding Role of Folates and Fluoropyrimidines in Cancer Chemotherapy.” Y. Rustum and J. McGuire, eds., Plenum Press. New York. 1988. pp.Google Scholar
  23. 23.
    C. J. Allegra. G.F. Egan, J.C. Drake, et al. The treatment of metastatic breast cancer with 5-fluorouracil and leucovorin. in: “International Symposium on the Expanding Role of Folates and Fluoropyrimidines in Cancer Chemotherapy.” Y. Rustum and J. McGuire, eds., Plenum Press, New York, 1988, pp.Google Scholar
  24. 24.
    J.H. Doroshow, L. Leong, K. Margolin. et al. Effective salvage therapy for refractory disseminated breast cancr with 5-fluorouracil and high-dose continuous infusion folinic acid. in: “International Symposium on the Expanding Role of Folates and Fluoropyrimidines in Cancer Chemotherapy,” Y. Rustum and J. McGuire, eds., Plenum Press, New York, 1988, pp.Google Scholar
  25. 25.
    C.L. Loprinzi, J.N. Ingle, D.J. Schaid, et al. Progress report on a phase II trial of 5-fluorouracil plus citrovorum factor in women with metastatic breast cancer. in: “International Symposium on the Expanding Role of Folates and Fluóropyrimidines in Cancer Chemotherapy,” Y. Rustum and J. McGuire, eds., Plenum Press, New York, 1988, pp.Google Scholar
  26. 26.
    G. Marini, E. Simoncini, A. Zaniboni, et al. Fluorouracil and high-dose folinic acid as salvage treatment of advanced breast cancer: an update. Oncology 44: 336 (1987).PubMedCrossRefGoogle Scholar
  27. 27.
    S. Fine, C. Erlichman, L. Kaizer, et al. Phase II trial of 5FU + folinic acid (FA) as first line treatment for metastatic breast cancer. Proc Am Soc Clin Oncol 7: 41 (1988).Google Scholar
  28. 28.
    A. Zaniboni, E. Simoncini, P. Marpicati, et al. Cyclophosphamide (C), epirubicin (E), high-dose folinic acid (HDFA) and 5-fluorouracil (5-FU) as first line chemotherapy in metastatic breast cancer (MBC). Preliminary results. Proc Am Soc Clin Oncol 7: 18 (1988).Google Scholar
  29. 29.
    D. Machover, E. Goldschmidt, P. Chollet, et al. Treatment of advanced colorectal and gastric adenocarcinomas with 5-fluorouracil and high-dose folinic acid. J Clin Oncol 4: 685 (1986).PubMedGoogle Scholar
  30. 30.
    S.G. Arbuck, H.O. Douglass, Jr., F. Trave, et al. A phase II trial of 5-fluorouracil and high-dose intravenous leucovorin in gastric carcinoma. J Clin Oncol 5: 1150 (1987).PubMedGoogle Scholar
  31. 31.
    H. W. Bruckner. Mount Sinai clinical experience with leucovorin and fluorouracil. in: “International Symposium on the Expanding Role of Folates and Fluóropyrimidines in Cancer Chemotherapy,” Y. Rustum and J. McGuire, eds., Plenum Press, New York, 1988, pp.Google Scholar
  32. 32.
    P.J. Creaven, H. Takita, Y. Rustum, et al. Unpublished data.Google Scholar
  33. 33.
    R.M. Evans, J.D. Laskin, M.T. Hakala. Effect of excess folates and deoxyinosine on the activity and site of action of 5-fluorouracil. Cancer Res 41: 3288 (1981).PubMedGoogle Scholar
  34. 34.
    S. Madajewicz, J.J. Fiore, M.H. Zarrabi. Clinical experience with 5-FU/DDP + OHDW combination chemotherapy in patients with advanced colorectal carcinoma. in: “International Symposium on the Expanding Role of Folates and F1uóropyrimidines in Cancer Chemotherapy,” Y. Rustum and J. McGuire, eds., Plenum Press, New York, 1988, pp.Google Scholar
  35. 35.
    W. Scheithauer, D. Depisch, R. Schiessel, et al. High dose leucovorin (CF), 5-fluorouracil (5-FU) and cisplatin (DDP) for treatment of metastatic colorectal cancer. Proc Am Soc Clin Oncol 7: 108 (1988).Google Scholar
  36. 36.
    V. Chiarion Sileni, F. Figoli, M. Gulisano, et al. 120 Hours 5-fluorouracil (5-FU) continuous infusion (c. i.) plus cisplatinum (P) and folinic acid (F) in metastatic colon cancer (M.C.C.). Proc Am Soc Clin Oncol 7: 109 (1988).Google Scholar
  37. 37.
    T.M. Loeffler, J. Lindemann, H. Luckhaupt, et al. Chemotherapy of advanced and relapsed squamous cell cancer of the head and neck with split-dose cisplatinum (DDP), 5-fluorouracil (Fura) and leucovorin (CF). in: “International Symposium on the Expanding Role of Folates and Fluóropyrimidines in Cancer Chemotherapy,” Y. Rustum and J. McGuire, eds., Plenum Press, New York, 1988, pp.Google Scholar

Copyright information

© Plenum Press, New York 1988

Authors and Affiliations

  • Patrick J. Creaven
    • 1
  1. 1.Department of Clinical Pharmacology and TherapeuticsRoswell Park Memorial InstituteBuffaloUSA

Personalised recommendations