A comprehensive review of 5-fluorouracil and leucovorin in patients with metastatic colorectal carcinoma

✍ Scribed by David Machover

• Publisher: John Wiley and Sons
• Year: 1997
• Tongue: English
• Weight: 112 KB
• Volume: 80
• Category: Article
• ISSN: 0008-543X
• DOI: 10.1002/(sici)1097-0142(19971001)80:7<1179::aid-cncr1>3.0.co;2-g

✦ Synopsis

Background:

Colorectal carcinoma is the third leading cause of cancer-related death. the primary treatment for patients with metastatic colorectal carcinoma is systemic chemotherapy with 5-fluorouracil (5-fu) and leucovorin (lv), a biomodulator of 5-fu that has been shown to enhance its activity. optimal dosing and administration strategies remain to be determined.

Methods:

This article is a review of recent studies reporting on the use of high dose and low dose lv as a biomodulator of 5-fu in patients with advanced colorectal carcinoma.

Results:

Studies of lv plus 5-fu demonstrated response rates of 7-58% in patients who had not received prior chemotherapy. a survival advantage was recorded in some trials. lv plus 5-fu produces mild and transient hematologic toxicity. the most common toxicities from lv plus 5-fu were gastrointestinal and schedule-dependent, but generally resolved within a few days.

Conclusions:

The combination of lv and 5-fu provides a favorable treatment regimen for patients with metastatic colorectal carcinoma. growing evidence suggests that altering the dose and schedule of both lv and 5-fu can impact positively on the response rate. however, controversy remains regarding the optimal dosing regimen. therefore, continued study of lv plus 5-fu is urged and a favorable impact on survival is requisite before definitive conclusions are drawn, particularly in relation to lv dosage.