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Original Articles
Feasibility of Oxaliplatin, Leucovorin, and 5-Fluorouracil (FOLFOX-4) Chemotherapy in Heavily Pretreated Patients with Recurrent Epithelial Ovarian Cancer
Hee Jun Lee, Hee Seung Kim, Noh Hyun Park, Hyun Hoon Chung, Jae Weon Kim, Yong Sang Song
Cancer Res Treat. 2013;45(1):40-47.   Published online March 31, 2013
DOI: https://doi.org/10.4143/crt.2013.45.1.40
AbstractAbstract PDFPubReaderePub
PURPOSE
The purpose of this study is to evaluate the efficacy and toxicity of oxaliplatin, leucovorin, and 5-fluorouracil (FOLFOX-4) chemotherapy in heavily pretreated patients with recurrent epithelial ovarian cancer (EOC).
MATERIALS AND METHODS
Clinical data were reviewed in 28 patients who received FOLFOX-4 as more than the second-line chemotherapy, consisting of 85 mg/m2 of oxaliplatin as a 2-hour infusion, 200 mg/m2 of leucovorin as a 2-hour infusion, and bolus 400 mg/m2 on day 1, followed by a 22-hour infusion of 600 mg/m2 of 5-fluorouracil for two consecutive days every three weeks. In addition, its efficacy and toxicity were compared with those reported in in three previous relevant studies.
RESULTS
A total of 128 cycles of FOLFOX-4 were administered with the median number of five cycles (range, 1 to 10 cycles). In nine patients with measurable disease, complete response (CR) and partial response (PR) were observed in 0 (0%) and two (22.2%) patients, whereas in 19 patients with non-measurable disease, CR and PR were observed in 0 (0%) and five (26.3%) patients. Among all patients, grade 3 anemia, neutropenia, and thrombocytopenia were observed in two (7.1%), three (10.7%), and one (3.6%) patient, and grade 3 fatigue, nausea and vomiting, and peripheral neuropathy were observed in one (3.6%), two (7.1%), and three (10.7%) patients. In addition, median values of time to progressive disease and chemotherapy-specific survival were three months (range, 0 to 10 months) and nine months (range, 4 to 24 months).
CONCLUSION
FOLFOX-4 is feasible as salvage chemotherapy with acceptable toxicity for heavily pretreated patients with recurrent EOC.

Citations

Citations to this article as recorded by  
  • Antitumour effects of a solid lipid nanoparticle loaded with gemcitabine and oxaliplatin on the viability, apoptosis, autophagy, and Hsp90 of ovarian cancer cells
    Ashwaq A. Al-Mutairi, Mayson H. Alkhatib
    Journal of Microencapsulation.2022; 39(5): 467.     CrossRef
  • In Vitro Employment of Recombinant Taenia solium Calreticulin as a Novel Strategy Against Breast and Ovarian Cancer Stem-like Cells
    Alejandro Schcolnik-Cabrera, Mandy Juárez, Bernardo Oldak, Mayra Cruz-Rivera, Ana Flisser, Alfonso Dueñas-González, Vinnitsa Buzoianu-Anguiano, Sandra Orozco-Suarez, Fela Mendlovic
    Archives of Medical Research.2020; 51(1): 65.     CrossRef
  • Mucinous Cancer of the Ovary: Overview and Current Status
    Abdulaziz Babaier, Prafull Ghatage
    Diagnostics.2020; 10(1): 52.     CrossRef
  • Oxaliplatin plus leucovorin and 5-fluorouracil (FOLFOX-4) as a salvage chemotherapy in heavily-pretreated platinum-resistant ovarian cancer
    Vincenza Conteduca, Giorgia Gurioli, Lorena Rossi, Emanuela Scarpi, Cristian Lolli, Giuseppe Schepisi, Alberto Farolfi, Delia De Lisi, Valentina Gallà, Salvatore Luca Burgio, Cecilia Menna, Andrea Amadori, Lorena Losi, Dino Amadori, Maria Paola Costi, Ugo
    BMC Cancer.2018;[Epub]     CrossRef
  • Malignant transformation of ovarian mature cystic teratoma into squamous cell carcinoma: a Taiwanese Gynecologic Oncology Group (TGOG) study
    An-Jen Chiang, Min-Yu Chen, Chia-Sui Weng, Hao Lin, Chien-Hsing Lu, Peng-Hui Wang, Yu-Fang Huang, Ying-Cheng Chiang, Mu-Hsien Yu, Chih-Long Chang
    Journal of Gynecologic Oncology.2017;[Epub]     CrossRef
  • Mucinous ovarian cancer: A therapeutic review
    Wen Xu, Jack Rush, Kirsty Rickett, Jermaine I.G. Coward
    Critical Reviews in Oncology/Hematology.2016; 102: 26.     CrossRef
  • Gemcitabine–oxaliplatin (GEMOX) for epithelial ovarian cancer patients resistant to platinum-based chemotherapy
    Mohamed Elshebeiny, Walid Almorsy
    Journal of the Egyptian National Cancer Institute.2016; 28(3): 183.     CrossRef
  • The American Society of Peritoneal Surface Malignancies Multi-Institution evaluation of 1,051 advanced ovarian cancer patients undergoing cytoreductive surgery and HIPEC: An introduction of the peritoneal surface disease severity score
    Richard Sleightholm, Jason M. Foster, Lynette Smith, Wim Ceelen, Marcello Deraco, Yusuf Yildirim, Edward Levine, Cristobal Muñoz-Casares, Olivier Glehen, Asish Patel, Jesus Esquivel
    Journal of Surgical Oncology.2016; 114(7): 779.     CrossRef
  • Ginseng Purified Dry Extract, BST204, Improved Cancer Chemotherapy-Related Fatigue and Toxicity in Mice
    Hyun-Jung Park, Hyun Soo Shim, Jeom Yong Kim, Joo Young Kim, Sun Kyu Park, Insop Shim
    Evidence-Based Complementary and Alternative Medicine.2015; 2015: 1.     CrossRef
  • A Series of Malignant Ovarian Cancers Arising From Within a Mature Cystic Teratoma
    Jonathan D. Black, Dana M. Roque, Monica C. Pasternak, Natalia Buza, Thomas J. Rutherford, Peter E. Schwartz, Shirley McCarthy, Elena Ratner
    International Journal of Gynecological Cancer.2015; 25(5): 792.     CrossRef
  • The efficacy and safety of Oxaliplatin-Vinorelbine as a second-line chemotherapy combination in patients with platinum-resistant pretreated epithelial ovarian cancer: A retrospective study
    Fidia Mumtahana, Xinli Tiang, Teng Zhang, Baoxia Cui
    International Journal of Cancer Therapy and Oncology.2014; 2(4): 020413.     CrossRef
  • Gastrointestinal Adverse Effects in Advanced Colorectal Carcinoma Patients Treated with Different Schedules of FOLFOX
    Nusrat Bano, Rahila Najam, Faaiza Qazi, Ahmed Mateen
    Asian Pacific Journal of Cancer Prevention.2014; 15(19): 8089.     CrossRef
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Phase II Study of Oxaliplatin, 5-fluorouracil, and Leucovorin in Relapsed or Metastatic Colorectal Cancer as Second Line Therapy
Duk-Joo Lee, Ho-Suk Oh, Jung-Hye Choi, Young-Yeul Lee, In-Soon Kim, Myung-Ju Ahn
Cancer Res Treat. 2006;38(4):201-205.   Published online December 31, 2006
DOI: https://doi.org/10.4143/crt.2006.38.4.201
AbstractAbstract PDFPubReaderePub
Purpose

The purpose of the study was to assess the efficacy and safety of biweekly oxaliplatin in combination with leucovorin (LV)-modulated bolus plus infusion of 5-fluorouracil (5-FU) in patients with relapsed or metastatic colorectal cancer (CRC) as a second line therapy.

Materials and Methods

Between November 2002 and October 2005, 26 patients with histologically confirmed relapsed or metastatic CRC were enrolled. All patients were previously treated with irinotecan-based combination chemotherapy. The chemotherapy regimen consisted of oxaliplatin 85 mg/m2 on day 1; LV 200 mg/m2 on days 1 and 2; and 5-FU 400 mg/m2 bolus IV with 600 mg/m2 with a 22-hour infusion on days 1 and 2 every 2 weeks.

Results

The median age of the 26 patients was 50.5 years (range, 31~72). Their metastatic sites included: the liver (42.3%), peritoneum (26.9%), lung (23.1%) and ovary (7.7%). Twenty five patients were evaluated for their response. Four patients achieved partial responses and 15 patients had stable disease. The overall response rate was 16% (95% confidence interval; 1.7~30.3%). The median follow-up duration for the surviving patients was 7.4 months (range, 2.08~21.2). Median overall survival (OS) and 1-year OS rates were 16.7 months and 63.9%, respectively. The most common hematological toxicities were: NCI grade I/II leucopenia (49.3%), grade I/II neutropenia (41%) and grade I/II anemia (65.2%). The main non-hematological toxicities were: grade I/II peripheral neuropathy (16.1% and 21.5%, respectively) and nausea/vomiting (23.6%/18.5%). There was no life-threatening toxicity.

Conclusion

The oxaliplatin, 5-FU and LV combination chemotherapy, scheduled as a biweekly protocol, was effective and well tolerated in the treatment of relapsed or metastatic colorectal cancer patients as second line chemotherapy.

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Review Article
Lapatinib - Overview and Current Role in Metastatic Breast Cancer
Arlene Chan
Cancer Res Treat. 2006;38(4):198-200.   Published online December 31, 2006
DOI: https://doi.org/10.4143/crt.2006.38.4.198
PDFPubReaderePub

Citations

Citations to this article as recorded by  
  • The landscape of exosomal non-coding RNAs in breast cancer drug resistance, focusing on underlying molecular mechanisms
    Malihe Rezaee, Fatemeh Mohammadi, Atoosa Keshavarzmotamed, Sheida Yahyazadeh, Omid Vakili, Yaser Eshaghi Milasi, Vida Veisi, Rohollah Mousavi Dehmordi, Sepideh Asadi, Seyedeh Sara Ghorbanhosseini, Mehdi Rostami, Mina Alimohammadi, Abbas Azadi, Nushin Mous
    Frontiers in Pharmacology.2023;[Epub]     CrossRef
  • Circular RNA circ-MMP11 Contributes to Lapatinib Resistance of Breast Cancer Cells by Regulating the miR-153-3p/ANLN Axis
    Xiaoli Wu, Yi Ren, Rong Yao, Leilei Zhou, Ruihua Fan
    Frontiers in Oncology.2021;[Epub]     CrossRef
  • Activated estrogen receptor‐mitogen‐activated protein kinases cross talk confer acquired resistance to lapatinib
    Zhe Li, Sheng‐Sheng Yang, Pei‐Hao Yin, Tao Chang, Lin‐Xiang Shi, Lin Fang, Guo‐En Fang
    Thoracic Cancer.2015; 6(6): 695.     CrossRef
  • Clinical features and outcome of leptomeningeal metastasis in patients with breast cancer: a single center experience
    Jae-Cheol Jo, Myoung Joo Kang, Jeong Eun Kim, Jin-Hee Ahn, Kyung Hae Jung, Gyungyub Gong, Hak Hee Kim, Seung Do Ahn, Su Ssan Kim, Byung Ho Son, Sei Hyun Ahn, Sung-Bae Kim
    Cancer Chemotherapy and Pharmacology.2013; 72(1): 201.     CrossRef
  • Lapatinib – kezelési lehetőség trastuzumab-rezisztens emlőrákban
    Béla Pikó
    Magyar Onkológia.2009; 53(4): 369.     CrossRef
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Original Articles
A Phase II Study of Irinotecan, 5-Fluorouracil and Leucovorin for Treatment in Patients with Previously Untreated Advanced Colorectal Cancer
Sang-Byung Bae, Nam-Su Lee, Han-Jo Kim, Kyoung-Ha Kim, Hyun-Jung Kim, Chan-Kyu Kim, Kyu-Taeg Lee, Sung-Kyu Park, Jong-Ho Won, Dae-Sik Hong, Hee-Sook Park
Cancer Res Treat. 2006;38(2):72-77.   Published online April 30, 2006
DOI: https://doi.org/10.4143/crt.2006.38.2.72
AbstractAbstract PDFPubReaderePub
Purpose

We prospectively conducted a non-randomized phase II trial to evaluate the efficacy and safety of combination irinotecan, leucovorin (LV) and 5-fluorouracil (FU) as a first-line regimen for treating patients with previously untreated advanced colorectal cancer (CRC).

Materials and Methods

Twenty-six previously untreated patients with advanced, recurrent or metastatic CRC were enrolled in this study. The patients received either irinotecan 180 mg/m2 on day 1 with LV bolus of 200 mg/m2 and FU bolus of 400 mg/m2, and this was followed by FU continuous infusion of 600 mg/m2 on day 1 and day 2 (the FOLFIRI regimen), or they were treated with LV bolus of 400 mg/m2 and FU bolus of 400 mg/m2 followed by FU continuous infusion of 2,400 mg/m2 for 46 hours (the simplified FOLFIRI regimen), and these treatments were repeated every 2 weeks until disease progression.

Results

The objective response rate was 23.1% (6/26) respectively, for both treatments. The median time to progression was 5.3 months (range: 0.4~19.9), and the overall survival was 11.2 months (range: 0.5~52.3). The prognostic factor for longer survival was the Eastern Cooperative Oncology Group (ECOG) performance status (PS). The non-hematological toxicities were similar for both treatment groups, with more frequent grade ≥3 neutropenia being noted for the simplified FOLFIRI regimen.

Conclusion

The biweekly irinotecan based regimen was demonstrated to have a moderate antitumor activity with acceptable toxicity profiles, and the ECOG PS was the independent prognostic factor.

Citations

Citations to this article as recorded by  
  • Oncological Treatment-Related Fatigue in Oncogeriatrics: A Scoping Review
    Louise André, Gabriel Antherieu, Amélie Boinet, Judith Bret, Thomas Gilbert, Rabia Boulahssass, Claire Falandry
    Cancers.2022; 14(10): 2470.     CrossRef
  • The use of high dose d,l-leucovorin in first-line bevacizumab+mFOLFIRI treatment of patients with metastatic colorectal cancer may enhance the antiangiogenic effect of bevacizumab
    B. Budai, T. Nagy, I. Láng, E. Hitre
    Angiogenesis.2013; 16(1): 113.     CrossRef
  • Successful Treatment of Small-Cell Lung Cancer With Irinotecan in a Hemodialysis Patient With End-Stage Renal Disease
    Dong Min Kim, Hyun Lee Kim, Choon Hae Chung, Chi Young Park
    The Korean journal of internal medicine.2009; 24(1): 73.     CrossRef
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Combination Chemotherapy of Oxaliplatin, 5-Fluorouracil and Low Dose Leucovorin in Patients with Advanced Colorectal Cancer
Yoon Mi Shin, Hae Suk Han, Seong Woo Lim, Byung Chul Kim, Kyung Suck Cheoi, Young Ook Eum, Seung Taek Kim, Ki Hyeong Lee
Cancer Res Treat. 2005;37(5):284-289.   Published online October 31, 2005
DOI: https://doi.org/10.4143/crt.2005.37.5.284
AbstractAbstract PDFPubReaderePub
Purpose

The aim of this study was to evaluate the efficacy and tolerability of the oxaliplatin, 5-fluorouracil (5-FU) and low dose leucovorin (LV) combination in patients with advanced colorectal cancer.

Materials and Methods

Patients with unresectable or recurrent colorectal carcinomas were prospectively accrued. Up to one prior chemotherapy regimen was allowed. Patients received oxaliplatin, 85 mg/m2, administered as a 2-hour infusion on day 1, followed by LV, 20 mg/m2, as a bolus and 5-FU, 1,500 mg/m2, via continuous infusion for 24 hours on days 1 and 2. Treatment was repeated every 2 weeks until disease progression or adverse effects prohibited further therapy.

Results

Between August 1999 and May 2004, 31 patients were enrolled in this study. Of the patients enrolled, 24 and 31 were evaluable for tumor response and survival analysis, respectively. The patients' characteristics included a median age of 59, with 6 (19%) having had prior chemotherapy. No patient achieved a complete response, but nine (38%) attained a partial response. Seven (29%) patients maintained a stable disease and 8 (33%) experienced increasing disease. The median duration of the response was 6 months. After a median follow-up of 9.6 months, the median time to progression was 3.8 months, with a median survival of 10.7 months. The hematological toxicities were mild to moderate, with no treatment-related mortality or infection. The major non-hematological toxicity was gastrointestinal toxicity.

Conclusion

The combination chemotherapy of oxaliplatin, low dose LV and continuous infusion of 5-FU is safe and has a cost-benefit, but is a moderately effective regimen in advanced colorectal cancer. A randomized trial comparing low and high dosages of leucovorin in the FOLFOX regimen is warranted.

Citations

Citations to this article as recorded by  
  • Extracellular vesicles derived from Lactobacillus plantarum restore chemosensitivity through the PDK2-mediated glucose metabolic pathway in 5-FU-resistant colorectal cancer cells
    JaeJin An, Eun-Mi Ha
    Journal of Microbiology.2022; 60(7): 735.     CrossRef
  • Prognostic and Predictive Role of Excision Repair Cross-complementation Group 1 and Thymidylate Synthase in Colorectal Carcinoma Patients Received FOLFOX Chemotherapy: An Immunohistochemical Study
    Dalia M. Badary, Mai M. Elkabsh, Hussam H. Mady, Adel Gabr, Sana S. Kroosh
    Applied Immunohistochemistry & Molecular Morphology.2020; 28(10): 741.     CrossRef
  • Outpatient-basis Chemotherapy of Oxaliplatin, 5-fluorouracil, and Leucovorin as First-line Treatment for Patients with Metastatic or Recurrent Colorectal Cancer
    Joon Ho Moon, Jong Gwang Kim, Sang Kyun Sohn, Jin Ho Baek, Yoon Young Cho, Yee Soo Chae, Byung Min Ahn, Shi Nae Kim, Soo Jung Lee, In Taek Lee, Gyu Seog Choi, Soo Han Jun
    Journal of Korean Medical Science.2007; 22(3): 400.     CrossRef
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Case Report
Carboxypeptidase-G2 Rescue in a Patient with High Dose Methotrexate-induced Nephrotoxicity
Eun Sil Park, Kyung Hee Han, Hyoung Soo Choi, Hee Young Shin, Hyo Seop Ahn
Cancer Res Treat. 2005;37(2):133-135.   Published online April 30, 2005
DOI: https://doi.org/10.4143/crt.2005.37.2.133
AbstractAbstract PDFPubReaderePub

A 13 year-old girl with osteosarcoma and pulmonary tumor recurrence developed acute renal failure following high dose methotrexate (12 g/m2) therapy, she had previously tolerated high dose methotrexate and her renal and hepatic functions were normal. Briefly, 48 hours after beginning methotrexate infusion her methotrexate concentration and creatinine level were 1338.8 µM/L and 5.8 mg/dl, respectively. Grade IV oral mucositis and neutropenia with fever developed at 144 hours after MTX infusion. Hydration and alkalinization were continued and leucovorin rescue was intensified based on the plasma MTX concentrations. Plasma exchange was performed twice and hemodialysis 3 times without problems, but methotraxate and creatinine levels remained high, 91.9 µM/L, and 2.5 mg/dl, respectively. After 3 courses of hemodialysis carboxypeptidase-G2 (CPDG2) was administered at 50 U/kg, intravenously over 5 minutes. After 15 minutes of CPDG2 (Voraxaze™) infusion, her plasma MTX concentration was 0.91 µM/L and no rebound elevation or side effects developed. Thirteen days post-MTX infusion her renal function had normalized. We report here our experience of a dramatic methotrexate level reduction caused by CPDG2 administration.

Citations

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  • Extracorporeal Treatment for Methotrexate Poisoning
    Marc Ghannoum, Darren M. Roberts, David S. Goldfarb, Jesper Heldrup, Kurt Anseeuw, Tais F. Galvao, Thomas D. Nolin, Robert S. Hoffman, Valery Lavergne, Paul Meyers, Sophie Gosselin, Tudor Botnaru, Karine Mardini, David M. Wood
    Clinical Journal of the American Society of Nephrology.2022; 17(4): 602.     CrossRef
  • Comparable efficacy with varying dosages of glucarpidase in pediatric oncology patients
    Jeffrey R. Scott, Yinmei Zhou, Cheng Cheng, Deborah A. Ward, Hope D. Swanson, Alejandro R. Molinelli, Clinton F. Stewart, Fariba Navid, Sima Jeha, Mary V. Relling, Kristine R. Crews
    Pediatric Blood & Cancer.2015; 62(9): 1518.     CrossRef
  • Resumption of high‐dose methotrexate after acute kidney injury and glucarpidase use in pediatric oncology patients
    Anthony M. Christensen, Jennifer L. Pauley, Alejandro R. Molinelli, John C. Panetta, Deborah A. Ward, Clinton F. Stewart, James M. Hoffman, Scott C. Howard, Ching‐Hon Pui, Alberto S. Pappo, Mary V. Relling, Kristine R. Crews
    Cancer.2012; 118(17): 4321.     CrossRef
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Original Articles
Phase II Study of Irinotecan, 5-Fluorouracil, and Leucovorin in Relapsed or Metastatic Colorectal Cancer as First-line Therapy
Young-Woong Won, Young-Hyo Lim, Ho-Yong Park, Ho-Suk Oh, Jung-Hye Choi, Young-Yeul Lee, In-Soon Kim, Il-Young Choi, Myung-Ju Ahn
Cancer Res Treat. 2004;36(4):235-239.   Published online August 31, 2004
DOI: https://doi.org/10.4143/crt.2004.36.4.235
AbstractAbstract PDFPubReaderePub
Background

The purpose of this study was to assess the efficacy and toxicity of biweekly irinotecan plus 5-fluorouracil (FU) and leucovorin (LV) in patients with relapsed or metastatic colorectal cancer.

Materials and Methods

Between March 2002 and May 2004, 24 patients with histologically confirmed relapsed or metastatic colorectal cancer were enrolled in this study. One chemotherapy cycle consisted of irinotecan 180 mg/m2 on days 1 and 15; 5-FU 400 mg/m2 bolus IV with 600 mg/m2 by a 22 hour intravenous infusion on days 1, 2, 15 and 16; and leucovorin 20 mg/m2 on days 1, 2, 15 and 16, every 4 weeks.

Results

The median age of the 24 was 57.5 years (range, 38~69). Their metastatic sites included: the liver (62.5%), lung (20.8%), peritoneum (16.7%), lymph node (12.5%), ovary (8.3%) and pelvis/vagina (8.3%). Twenty-two patients were evaluable for a response. Six and 7 patients achieved partial responses and stable diseases, respectively. The overall response rate was 27.3% (95% Confidence interval; 10.3~44.5%). The median follow-up duration for surviving patients was 14.7 months (range, 1.7~26.5). Median overall survival (OS) and 1-year OS rates were 19 months and 86.3%, respectively. Median response duration and median progression free survival were 7.47 and 5.57 months, respectively. A total of 83 cycles (median 4 cycles) were administered. The main non-hematologic toxicities were nausea/vomiting (44.5%/18.1%) and diarrhea (8.4%). The most common hematologic toxicity was NCI grade I/II anemia (31.3%) and grade I/II neutropenia was 10.8%. There was no life-threatening toxicity.

Conclusion

The results suggested that irinotecan, 5-FU and leucovorin combination chemotherapy in a biweekly schedule is a practical and tolerable treatment option in patients with advanced colorectal cancer.

Citations

Citations to this article as recorded by  
  • A Phase I Study of UGT1A1 *28/*6 Genotype-Directed Dosing of Irinotecan (CPT-11) in Korean Patients with Metastatic Colorectal Cancer Receiving FOLFIRI
    Kyu-Pyo Kim, Yong Sang Hong, Jae-Lyun Lee, Kyun Seop Bae, Ho-Sook Kim, Jae-Gook Shin, Jung Shin Lee, Tae Won Kim
    Oncology.2015; 88(3): 164.     CrossRef
  • Effect of an Irinotencan, 5-Fluorouracil, and Leucovorin Combination Chemotherapy (FOLFIRI) in Metastatic Colorectal Cancer
    Seung Hyun Lee, Byung Kwon Ahn, Sung Uhn Baek
    Journal of the Korean Society of Coloproctology.2007; 23(5): 333.     CrossRef
  • A Phase II Study of Irinotecan, 5-Fluorouracil and Leucovorin for Treatment in Patients with Previously Untreated Advanced Colorectal Cancer
    Sang-Byung Bae, Nam-Su Lee, Han-Jo Kim, Kyoung-Ha Kim, Hyun-Jung Kim, Chan-Kyu Kim, Kyu-Taeg Lee, Sung-Kyu Park, Jong-Ho Won, Dae-Sik Hong, Hee-Sook Park
    Cancer Research and Treatment.2006; 38(2): 72.     CrossRef
  • Irinotecan, Continuous 5-Fluorouracil, and Low dose of Leucovorin (modified FOLFIRI) as First Line of Therapy in Recurrent or Metastatic Colorectal Cancer
    Myung-Ah Lee, Jae-Ho Byun, Byoung-Young Shim, In-Sook Woo, Jin-Hyung Kang, Young Seon Hong, Kyung Shik Lee, Myung Gyu Choi, Suk Kyun Chang, Seong Taek Oh, Sung Il Choi, Doo Suk Lee
    The Korean Journal of Internal Medicine.2005; 20(3): 205.     CrossRef
  • Responsiveness of CPT-11 in Respect to hMLH1 and hMSH2 Protein Expression in the Primary Colorectal Cancer
    In Ja Park, Hee Cheol Kim, Chang Sik Yu, Heung Moon Chang, Jea Hwan Lee, Jong Hoon Kim, Tae Won Kim, Jung Sun Kim, Jin Cheon Kim
    Cancer Research and Treatment.2004; 36(6): 360.     CrossRef
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The Efficacy of a Modified Chronomodulated Infusion of Oxaliplatin, 5-Fluorouracil and Leucovorin in Advanced Colorectal Cancer (Preliminary Data)
Ji Young Park, Si-Young Kim, Jae Jin Lee, Hwi Joong Yoon, Kyung Sam Cho
Cancer Res Treat. 2004;36(3):199-204.   Published online June 30, 2004
DOI: https://doi.org/10.4143/crt.2004.36.3.199
AbstractAbstract PDFPubReaderePub
Purpose

To determine the efficacy and tolerability of a modified chronomodulated infusion of oxaliplatin, 5-fluorouracil (5-FU) and leucovorin in the treatment of advanced colorectal cancer.

Materials and Methods

Sixteen patients with relapsed or metastatic colorectal cancer were treated with an intravenous infusion of oxaliplatin 25 mg/m2, 5-FU 700 mg/m2 and leucovorin 20 mg/m2 on days 1 to 5. The infusion of oxaliplatin was chronomodulated with a peak delivery rate at 16:00 p.m., with 5-FU infused constantly overnight. Each course was repeated every 21 days.

Results

The response rate was 38.5% (95% confidence interval [CI], 13.9% to 68.4%) in the 13 measurable patients, including 1 complete response (7.7%) and 4 partial responses (30.8%). Five patients (38.5%) had a stable disease and 3 (23.0%) a progressive disease. Three patients without a measurable lesion had improved status. The median time to progression and overall survival were 29 weeks and 85 weeks, respectively. Grade 3 thrombocytopenia occurred in 2.5% (2 cycles) and grade 3 vomiting in 12.5% (2 patients). Anorexia, stomatitis, diarrhea, pruritus, alopecia and peripheral neuropathy were mild and tolerable.

Conclusion

The modified chronomodulated infusion of oxaliplatin, 5-FU and leucovorin is effective and tolerable, but the number of patients was too small. Further study will be needed to confirm the efficacy of this regimen with a larger population of patients.

Citations

Citations to this article as recorded by  
  • Combination Chemotherapy of Oxaliplatin, 5-Fluorouracil and Low Dose Leucovorin in Patients with Advanced Colorectal Cancer
    Yoon Mi Shin, Hae Suk Han, Seong Woo Lim, Byung Chul Kim, Kyung Suck Cheoi, Young Ook Eum, Seung Taek Kim, Ki Hyeong Lee
    Cancer Research and Treatment.2005; 37(5): 284.     CrossRef
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Randomized Phase III Trial of Cisplatin, Epirubicin, Leucovorin, 5-Fluorouracil (PELF) Combination versus 5-fluorouracil Alone as Adjuvant Chemotherapy in Curative Resected Stage III Gastric Cancer
Jae Jin Lee, Si-Young Kim, Im sik Shin, Kyung Sam Cho, Hoong-Zae Joo, Choong Yoon, Yoon Wha Kim, Hwi Joong Yoon
Cancer Res Treat. 2004;36(2):140-145.   Published online April 30, 2004
DOI: https://doi.org/10.4143/crt.2004.36.2.140
AbstractAbstract PDFPubReaderePub
Purpose

The combination of cisplatin, epirubicin, leucovorin and 5-fluorouracil (PELF) administration, as adjuvant chemotherapy after curative resection for gastirc cancer, was compared with 5-fluorouracil (5-FU) administration alone. This paper reports the results of a prospective randomized comparison of the two regimens, PELF and 5-FU.

Methods

From August 1996 to July 1999, 54 patients were selected subsequent to being diagnosed with stage III cancer after a curative resection for gastric cancer. The patients were stratified according to stage IIIA/IIIB and subtotal/total gastrectomy, and then they were randomized into each treatment group, i.e. the PELF or 5-FU alone groups.

Results

54 assessable patients were enrolled in this study: 28 received PELF and 26 received 5-FU alone. 12 patients relapsed in each group and the median follow-up duration was 42 months (range: 10~77 months). The overall survival rate and disease-free survival rate (DFS) were not significantly different between two groups, (5-year survival of PELF vs. 5-FU: 57% vs. 64%, 5-year DFS: 54% vs. 51%). The PELF combination was more toxic in terms of anemia, anorexia, nausea and diarrhea than the 5-FU.

Conclusions

This study showed that the PELF combination, as an adjuvant therapy for gastric cancer after a curative resection, was a less effective treatment, and it had more toxic effects than the 5-FU.

Citations

Citations to this article as recorded by  
  • Multidisciplinary treatment strategy for locally advanced gastric cancer: A systematic review
    Kotaro Sugawara, Yoshikuni Kawaguchi, Yasuyuki Seto, Jean-Nicolas Vauthey
    Surgical Oncology.2021; 38: 101599.     CrossRef
  • The Efficacy and Safety of (Neo)Adjuvant Therapy for Gastric Cancer: A Network Meta-analysis
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    Cancers.2019; 11(1): 80.     CrossRef
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    Cancers.2019; 11(4): 530.     CrossRef
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    Frontiers in Oncology.2019;[Epub]     CrossRef
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    Zhaolun Cai, Yiqiong Yin, Yuan Yin, Chaoyong Shen, Jian Wang, Xiaonan Yin, Zhixin Chen, Ye Zhou, Bo Zhang
    Gastric Cancer.2018; 21(6): 1031.     CrossRef
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Oxaliplatin with Biweekly, Low Dose Leucovorin and Bolus and Continuous Infusion 5-fluorouracil (Modified FOLFOX 4) as First-line Therapy for Patients with Metastatic Colorectal Cancer
Hyuk-Chan Kwon, Kyoung Tae Kim, Shin Ae Lee, Jong-Sung Park, Sung-Hyun Kim, Jae-Seok Kim, Hyo Jin Kim
Cancer Res Treat. 2004;36(2):115-120.   Published online April 30, 2004
DOI: https://doi.org/10.4143/crt.2004.36.2.115
AbstractAbstract PDFPubReaderePub
Purpose

To determine the activity and toxicities of low dose leucovorin (LV) plus fluorouracil (5-FU) regimen, combined with oxaliplatin every two weeks (modified FOLFOX 4), as a first-line therapy for patients with metastatic colorectal cancer.

Materials and Methods

Between March 2001 and August 2003, fifty-five patients were enrolled in this study. Patients were treated with oxaliplatin 85 mg/m2 as a 2-hour infusion at days 1 plus LV 20 mg/m2 over 10 minutes, followed by 5-FU bolusa 400 mg/m2 bolus and 22 hour continuous infusion of 600 mg/m2 5-FU at day 1~2. This treatment was repeated in 2 week intervals.

Results

The objective response rate was 40% on an intent-to-treatment analysis. Three patients (6%) demonstrated a complete response and nineteen patients (38%) showeda partial response. Sixteen patients (32%) showed a stable disease and eleven patients (22%) progressed during the course of the treatment. The median time to progression and overall survival time wereas 6.6 months (95% CI: 4.98~8.02 months) and the median overall survival time was 17.0 months (95% CI: 9.15~24.85 months) from the start of the chemotherapy, respectively. A total of 275 cycles were analyzed for toxicity. Major hematologic toxicities included grade 1~2 anemia (23.5%), neutropenia (25.3%) and thrombocytopenia (10.6%). There were only 2 cycles of neutropenic fever. The most common non-hematologic toxicities were grade 1~2 nausea/vomiting (10.9%), diarrhea (9.1%) and grade 1 neuropathy (18.0%). There was no treatment related death.

Conclusion

The modified folfox 4 regimen is safe and effective regimen as a first-line therapy in advanced colorectal cancer patients.

Citations

Citations to this article as recorded by  
  • A Phase II Study of Modified FOLFOX4 for Colorectal Cancer Patients with Peritoneal Carcinomatosis
    Dong Hyun Lee, Sung Yong Oh, Yu Rim Lee, Seok Jae Huh, Hyun Hwa Yoon, Sung Hyun Kim, Suee Lee, Ji Hyun Lee, Young Kim, Hyo-Jin Kim, Hyuk-Chan Kwon
    Cancer Research and Treatment.2011; 43(4): 225.     CrossRef
  • Outpatient-basis Chemotherapy of Oxaliplatin, 5-fluorouracil, and Leucovorin as First-line Treatment for Patients with Metastatic or Recurrent Colorectal Cancer
    Joon Ho Moon, Jong Gwang Kim, Sang Kyun Sohn, Jin Ho Baek, Yoon Young Cho, Yee Soo Chae, Byung Min Ahn, Shi Nae Kim, Soo Jung Lee, In Taek Lee, Gyu Seog Choi, Soo Han Jun
    Journal of Korean Medical Science.2007; 22(3): 400.     CrossRef
  • Oxaliplatin/5-FU without Leucovorin Chemotherapy in Metastatic Colorectal Cancer
    Byoung Yong Shim, Kang Moon Lee, Hyeon-Min Cho, Hyun Jin Kim, Hong Joo Cho, Jinmo Yang, Jun-Gi Kim, Hoon-Kyo Kim
    Cancer Research and Treatment.2005; 37(4): 212.     CrossRef
  • Combination Chemotherapy of Oxaliplatin, 5-Fluorouracil and Low Dose Leucovorin in Patients with Advanced Colorectal Cancer
    Yoon Mi Shin, Hae Suk Han, Seong Woo Lim, Byung Chul Kim, Kyung Suck Cheoi, Young Ook Eum, Seung Taek Kim, Ki Hyeong Lee
    Cancer Research and Treatment.2005; 37(5): 284.     CrossRef
  • Oxaliplatin with Biweekly Low Dose Leucovorin and Bolus and Continuous Infusion of 5-fluorouracil (Modified FOLFOX 4) as a Salvage Therapy for Patients w ith Advanced G astric Cancer
    Sung-Hwan Suh, Hyuk-Chan Kwon, Ji-Hoon Jo, Young-Rak Cho, Bong-Gun Seo, Dong-Mee Lee, Sung-Hyun Kim, Jae-Seok Kim, Hyo-Jin Kim
    Cancer Research and Treatment.2005; 37(5): 279.     CrossRef
  • Oxaliplatin: Is It a New Standard Weapon for Colorectal Cancer?
    Si-Young Kim
    Cancer Research and Treatment.2004; 36(2): 91.     CrossRef
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Infusional 5-Fluorouracil, Leucovorin and Docetaxel in Advanced Gastric Cancer
Yong Tai Kim, Joo Hyuk Sohn, So Hun Kim, Sun Young Rha, Chul Kim, Jae Kyung Roh, Byung Soo Kim, Woo Ick Jang, Hyun Cheol Chung
Cancer Res Treat. 2003;35(2):123-129.   Published online April 30, 2003
DOI: https://doi.org/10.4143/crt.2003.35.2.123
AbstractAbstract PDF
PURPOSE
This study was performed to estimate the response rate and toxicity of a combination chemotherapy, which included infusional 5-Fluorouracil, Leucovorin and Docetaxel in the treatment of patients with an advanced gastric carcinoma. MATERIALS AND METHODS: Twenty two advanced gastric cancer patients, with a bidimensionally measurable or an evaluable disease, were enrolled in this study. The patients received a 5-fluorouracil 1, 000 mg/m2 intravenous (IV) 24 hour infusion (Day 1~3), leucovorin 20 mg/m2 (Day 1~3) and docetaxel 75 mg/m2 intravenously (Day 2) every 3 weeks. RESULTS: The overall response rate was 45.0%. The median duration of response was 10.0 weeks (range: 4~24), the median time to response was 8 weeks (range: 8~20) the median time to progression was 30.0 weeks (95% CI: 16.3~43.2) and the median overall survival duration was 36.0 weeks (95% CI: 1.7~70.2). The median cumulative dose of 5-fluorouracil were 316.2 mg/m2/week and docetaxel was 23.9 mg/m2/week. WHO grade III, IV neutropenia, thromocytopenia and anemia occurred in 50.0%, 4.5% and 4.5% of patients, respectively. There were no occurrence of WHO grade III and IV nausea, vomiting, mucositis, conspitation, diarrhea, or neurotoxicity. CONCLUSION: This chemotherapy regimen, including infusional 5-fluorouracil, leucovorin and docetaxel was an active agent against advanced gastric cancer patients, especially for previous chemotherapy naive patients.

Citations

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  • The Efficacy of Docetaxel and Cisplatin Combination Chemotherapy for the Treatment of Advanced Gastric Cancer after Failing to 5-Fluorouracil Based Chemotherapy
    Sang-Joon Shin, Min-Kyoung Kim, Kyung-Hee Lee, Myung-Soo Hyun, Sang Woon Kim, Sun Kyo Song, Sung-Hwa Bae, Hun-Mo Ryoo
    Cancer Research and Treatment.2004; 36(6): 367.     CrossRef
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A Phase II Study of Oxaliplatin Combined with 5-Fluorouracil and Leucovorin (Mayo Clinic Regimen) in 5-Fluorouracil Refractory Colorectal Cancer
Yee Zee Bae, Jae Hyuk Jung, Chang Hoon Moon, Seong Hyun Kim, Hyuk Chan Kwon, Jae Seok Kim, Hyo Jin Kim
Cancer Res Treat. 2002;34(3):218-222.   Published online June 30, 2002
DOI: https://doi.org/10.4143/crt.2002.34.3.218
AbstractAbstract PDF
PURPOSE
There are few therapeutic options in patients with colorectal cancer that have progressed or recurred following 5-fluorouracil (5-FU) based therapy. We evaluated the efficacy and toxicity of oxaliplatin, 5-FU, leucovorin (Mayo clinic regimen) in 5-FU pretreated advanced colorectal cancer patients. MATERIALS AND METGODS: Twenty-eight patients were enrolled in this study between January 1999 and May 2001. Patients were treated with oxaliplatin 150 mg/m2 on day 1 as a 2-hr infusion and 5-FU 425 mg/m2, leucovorin 20 mg/m2, bolus for 5 days. Treatment courses were repeated in 4-week intervals.
RESULTS
The objective response rate was 25% for 28 assessable patients, all cases registered a partial response. Eleven patients (39%) demonstrated stable disease, and ten (36%) progressed. The median response duration was 5.5 months, and the median time to progression was 6.3 months. The median overall survival time was 13.5 months from the start of the chemotherapy. From the 120 cycles analyzed, grade 3,4 hematologic toxicities included neutropenia: 1.6%, and thrombocytopenia: 1.6%. The frequent grade 3.4 non-hematologic adverse reactions were nausea/vomiting (25.0%), diarrhea (14.3%), stomititis (3.6%), and neuropathy (3.6%). There were no treatment-related deaths.
CONCLUSION
This phase II study had relatively higher toxicity than previous studies, and did not show an increased significant response rate. These high levels of toxicity suggest that the study treatment combination of oxaliplatin with a full dose Mayo clinic regimen arm is no feasible. Therefore, this regimen will be discontinued and a safer regimen will be adopted.

Citations

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  • Effect of Betulinic Acid on Anticancer Drug‐Resistant Colon Cancer Cells
    Gwon‐Ryul Jung, Kyung‐Jong Kim, Cheol‐Hee Choi, Tae‐Beum Lee, Song Iy Han, Hyo‐Kyung Han, Sung‐Chul Lim
    Basic & Clinical Pharmacology & Toxicology.2007; 101(4): 277.     CrossRef
  • Oxaliplatin/5-FU without Leucovorin Chemotherapy in Metastatic Colorectal Cancer
    Byoung Yong Shim, Kang Moon Lee, Hyeon-Min Cho, Hyun Jin Kim, Hong Joo Cho, Jinmo Yang, Jun-Gi Kim, Hoon-Kyo Kim
    Cancer Research and Treatment.2005; 37(4): 212.     CrossRef
  • The Efficacy of a Modified Chronomodulated Infusion of Oxaliplatin, 5-Fluorouracil and Leucovorin in Advanced Colorectal Cancer (Preliminary Data)
    Ji Young Park, Si-Young Kim, Jae Jin Lee, Hwi Joong Yoon, Kyung Sam Cho
    Cancer Research and Treatment.2004; 36(3): 199.     CrossRef
  • Oxaliplatin with Biweekly, Low Dose Leucovorin and Bolus and Continuous Infusion 5-fluorouracil (Modified FOLFOX 4) as First-line Therapy for Patients with Metastatic Colorectal Cancer
    Hyuk-Chan Kwon, Kyoung Tae Kim, Shin Ae Lee, Jong-Sung Park, Sung-Hyun Kim, Jae-Seok Kim, Hyo Jin Kim
    Cancer Research and Treatment.2004; 36(2): 115.     CrossRef
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Phase II Trial of Gemcitabine, UFT-E, Leucovorin Combination Chemotherapy in Advanced Pancreatic Adenocarcinoma
So Young Yoon, Kyong Hwa Park, Sang Chul Oh, Jae Hong Seo, Chul Won Choi, Byung Soo Kim, Jae Seon Kim, Chang Duck Kim, Sang Won Shin, Yeul Hong Kim, Jun Suk Kim
Cancer Res Treat. 2002;34(2):111-116.   Published online April 30, 2002
DOI: https://doi.org/10.4143/crt.2002.34.2.111
AbstractAbstract PDF
PURPOSE
To evaluate the efficacy and toxicity of a Gemcitabine, UFT-E, Leucovorin combination chemotherapy in the treatment of advanced pancreatic adenocarcinoma. PATIENTS AND METHODS: Patients <=70 years, with no prior chemotherapy and with bidimensionally measurable advanced pancreatic adenocarcinoma, ECOG performance status <=2, and adequate bone marrow, kidney, and liver function were eligible for this trial. Eligibility criteria for clinical benefit assessment were pain with at least a daily analgesic consumption of two nonsteroidal anti-inflammatory drugs or a Karnofsky performance status between 50 and 70. Treatment consisted of 1,000 mg/m2 of Gemcitabine on days 1, 8 and 15, repeated every 4 weeks, with UFT-E administered orally 500 mg-700 mg by body surface area (BSA). Leucovorin was administered 45 mg/day orally. Dosages of UFT-E and Leucovorin were divided and administered three times per day from day 1 to day 21. After 7 days of rest, UFT-E and Leucovorin were administered repeatedly.
RESULTS
Twenty-three patients were enrolled between April 1999 to April 2000. Eighty two cycles (median, four cycles) were delivered to all patients. The objective response rate was 15.8% in 19 assessable patients and 13.0% in the intent-to-treat population. Twelve patients (57.9%) displayed stable disease. Grade 3 or 4 neutropenia occurred in 30.4% of patients, nausea/vomiting in 8.3%, diarrhea in 4.3%, and mucositis in 4.3%. The median time to progression was 8 months. The median survival was 8 months in the assessable population and 6 months in the intent-to-treat population Clinical benefit was achieved in 11 (57.9%) of 19 assessable patients.
CONCLUSION
Gemcitabine, UFT-E, Leucovorin combination chemotherapy is a well-tolerated and safe regimen in cases of advanced pancreatic adenocarcinoma. Although the response rate is low, it shows a survival benefit and clinical benefit and deserves further evaluation in a phase III trial.

Citations

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  • Gemcitabine and oxaliplatin combination as first-line treatment for advanced pancreatic cancer: a multicenter phase II study
    Kyung Hee Lee, Min Kyoung Kim, Yeol Hong Kim, Baek Yeol Ryoo, Ho Yeong Lim, Hong Suk Song, Hoon Kyo Kim, Myung Ah Lee, Seock Ah Im, Heung Moon Chang, Jae Yong Cho, Dae Young Zang, Bong Seog Kim, Jun Suk Kim
    Cancer Chemotherapy and Pharmacology.2009; 64(2): 317.     CrossRef
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A Phase II Trial of UFT-E and Oral Leucovorin in Advanced Colorectal Cancer
Won Sup Lee, Keun Seok Lee, Ki Hyun Kim, Baek Yeol Ryoo, Won Seog Kim, Won Ki Kang, Yoon Koo Kang, Dae Seog Heo, Yung Jue Bang, Noe Kyeong Kim
Cancer Res Treat. 2001;33(3):225-228.   Published online June 30, 2001
DOI: https://doi.org/10.4143/crt.2001.33.3.225
AbstractAbstract PDF
PURPOSE
To determine the efficacy and toxicity of UFT-E plus oral calcium leucovorin in the treatment of patients with advanced colorectal cancer.
MATERIALS AND METHODS
Forty-three patients with advanced, bidimensionally measurable colorectal adenocarcinoma were enrolled in the trial. No patients had received prior palliative chemotherapy. The patients that had received previous adjuvant chemotherapy were enrolled when more than 6 months had elapsed after the completion of adjuvant therapy. Patients were treated with 300 mg/m2/day of UFT-E (tegafur-based) plus 90 mg/day of leucovorin administered orally in three divided daily doses, every 8 hours for 28 days followed by a 7-day rest period. Response was evaluated after two or three courses of therapy.
RESULTS
Thirty-six of forty-three patients were evaluable for response; seven dropped out due to infection, toxicity and patients' refusal. Ten patients had partial responses and one patient complete response (response rate, 31%; 95% confidence interval, 16~46%). The median response duration for the UFT-E plus leucovorin regimen was 28 weeks. Grade III toxicity was seen in one case, with diarrhea.
CONCLUSION
This oral regimen proved effective and well tolerated. This schema also avoided inconveniences, such as hospitalization and the use of infusion pumps, which are associated with 5-FU infusion regimens. The regimen used showed minimal toxicity, especially in the upper digestive tract, with good patient compliance.
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A Phase II Study of Oxaliplatin, 5-Fluorouracil, and Leucovorin in 5- Fluorouracil-Pretreated Metastatic Colorectal Cancer
Keun Seok Lee, Won Sup Lee, Hark Kyun Kim, Joo Young Jeong, Dae Seog Heo, Yung Jue Bang, Noe Kyeong Kim
J Korean Cancer Assoc. 2001;33(2):99-105.
AbstractAbstract PDF
PURPOSE
To evaluate antitumor response, time to progression, and toxicities of oxaliplatin, 5- fluorouracil (5-FU), and leucovorin (LV) continuous infusion in patients with metastatic colorectal cancer who progressed during or after treatment with a 5-FU-containing regimen.
MATERIALS AND METHODS
Forty-eight patients with metastatic colorectal cancer, who progressed while receiving or after discontinuing palliative chemotherapy with 5- FU-based regimen, were enrolled in this study. Treatment consisted of oxaliplatin (85 mg/m2 on day 1) as a 2-hour infusion followed by bolus 5-FU (400 mg/m2 on day 1), and 5-FU 48-hour infusion 2.4~3 g/m2 concurrently with LV 48-hour infusion 150 mg/m2, without mixing. Cycles were repeated at 2-week intervals. The dose of 5-FU was modified, depending on the hematologic toxicity profile.
RESULTS
The objective response rate was 28% for 43 assessable patients (95% confidence interval, 14% to 42%), including one complete remission (2%). Seventeen additional patients (39%) had stable disease, and fourteen (33%) progressed. The median time to progression was 5.9 months and the median overall survival was 13.2 months from the start of the chemotherapy. From the 297 cycles analyzed, hematologic toxicities per course were: leukopenia; grade I 26.6%, grade II 3.4%, and grade III 0.3%, thrombocytopenia; grade I 10.8%, grade II 3.0%, grade III 1.0%, and grade IV 0.3%. The most frequent nonhematologic adverse reactions were nausea/vomiting and peripheral neuropathy, which were rated as WHO grade II in 13 patients (49%) and 11 patients (22%), respectively.
CONCLUSION
This phase II study of oxaliplatin, 5-FU, and LV continuous infusion showed enhanced antitumor activity in patients with 5-FU-pretreated metastatic colorectal cancer. Overall toxicity was acceptable; neurotoxicity and bone marrow suppression constituted the dose-limiting side effects.
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5-Fluorouracil, Leucovorin ( FL ) Combination Chemotherapy in Advanced or Recurrent Colo - rectal Cancer
Jeong Hwan Cho, Hyuk Chan Kwon, Hyo Jin Kim
J Korean Cancer Assoc. 1999;31(5):1003-1010.
AbstractAbstract PDF
PURPOSE
We studied the effectiveness and toxicities of 5-fluorouracil+leucovorin, combination chemotherapy in advanced or recurred colo-rectal cancer patients, who didn't have previous chemotherapy and enrolled from August 1993 to July 1998.
MATERIALS AND METHODS
All patients were treated with leucovorin followed by 5-fluorouracil for 5 consecutive days every 4 weeks. Among 43 patients who were enrolled, 40 patients received treatment at least 2 courses, and they were evaluable. Male to female ratio was 21 to 19. In serum CEA level, 27 patients were greater than 5 ng/ml and 13 were less than 5 ng/ml. And primary site was colon in 21 patients and rectum in 19 patients.
RESULTS
The complete response rate was 7,5% and the partial response rate was 25%. The median survival duration was 14.7 months, the median response duration was 16.0 months, and median time to progression was 7.3 months. In the analysis of response, survival duration, time to progression according to various characteristics of patients, serum CEA level and liver involvement were revealed significant difference in survival duration, time to progression (p=0.0122, 00350 & 0.0202, 0.0123) on univariate analysis, but no significant difference on multivariates. Hematologic and non-hematologic toxicities were mild and tolerable.
CONCLUSION
This study indicates that the combination of 5-fluorouracil (370 mg/m) and leucovorin (20 mg/m) is effective and tolerable regimen in advanced or recurred colo-rectal cancer patients without previous chemotherapy.
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Post-operative Adjuvant Chemotherapy with 5-Fluorouracil, Leucovorin, and Mitomycin C (MLF) for Gastric Cancer
Jong Ho Chun, Dong Kyu Kim, Moon Suk Jo, Hyeong Jun Kim, Jung Il Won, Sung Rok Kim, Hong Yong Kim
J Korean Cancer Assoc. 1997;29(5):791-799.
AbstractAbstract PDF
PURPOSE
The surgical resection has been still the only curative treatment modality for the gastric cancer, but the overall prognosis has not been so satisfactory because of high relapse rate. So the necessity of adjuvant chemotherapy has been increased. We evaluated the effect of MLF (5-fluorouracil, leucovorin and mitomycin C) regimen on the prevention of relapse and survival benefit after postopertive adjuvant chemotherapy.
MATERIALS AND METHOD
The MLF regimen consisted of 5-FU 375 mg/m2 IV on days 1 through 5; LV 20 mg/m2 IV just before 5-FU infusion on days 1 through 5; and MMC 9 mg/m2 IV on day 1 (7 mg/m2 from the 2nd cycle).
RESULTS
One hundred patients were entered into the trial; 56 were male & 44 female, and the range of age was 20 to 82. The total number of chemotherapy cycles was 514. According to AJCC staging, 4 cases were in stage IA, 14 IB, 23 II, 42 IIIA, 15 IIIB, respectively and 2 cases were in stage IV. The estimated median survival was 32 months in stage IIIA, and 28 months in IIIB. The 5 year survival was 90% in stage IB, 76% in II, 29.6% in IIIA and 21.8% in IIIB. Severe neutropenia (WHO grade > or = 3) was observed in 11.8%, and throbocytopenia 0.4%. Severe nausea and vomiting was observed in 1.8%, diarrhea in 1.7%, and mucositis in 1.5%, but there was no toxic death.
CONCLUSION
The MLF adjuvant chemotherapy may be effective for resectable gastric cancer with minimal toxicities, but phase III study is needed to confirm its efficacy.
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5-Fluorouracil, Leucovorin, Ifosfamide and Cisplatin (FLIP) Combination Chemotherapy for Adevanced Non-Small Cell Lung Cancer
Hyun Sik Jeong, Keunchil Park, Jung Ae Lee, Young Iee Park, In Sook Woo, Ki Suk Jung, Young Suk Park, Duk Jhe Shun, Won Seog Kim, Jeong A Kim, Sung Soo Yoon, Won Ki Kang, Hong Ghi Lee, Chan Hyung Park
J Korean Cancer Assoc. 1997;29(1):46-52.
AbstractAbstract PDF
PURPOSE
To evaluate the response rate and toxicity of combination chemotherapy including 5-fluorouracil (F), leucovorin (L), ifosfamide (I) and cisplatin (P) for the previously untreated patients with unresectable stage IIIB or IV non-small cell lung cancer.
MATERIALS AND METHOD
The doses of FLIP were 5-fluorouracil 800 mg/m2 CI days 1-5, leucovorin 20 mg/m2 IV days 1-5, ifosfamide 1000 mg/m2 CI days 1-3, cisplatin 100 mg/m2 IV day 1 respectively. Cycles were repeated every 3 weeks until disease progression. Seventy-three previously untreated patients were enrolled. Age ranged from 30 to 73 (median 56 years); 43 were male, 30 female. Fifty-three patients had performance status (ECOG) 0-1 and 19 performance status 2. Twenty-two patients had stage IIIB and 51 stage IV. Follow-up ranged from 7+ to 160weeks (median 57 weeks).
RESULTS
The overall response rate was 46.7% for 62 evaluable patients. (CR 1 patient, PR 28 patients) Median response duration was 24 weeks (range 1+ to 36+ weeks). Toxicity > Grade II (WHO) included: granulocytopenia 19.8%, anemia 13.5%, nausea and vomiting 31.5% stomatitis 46.5%, neuropathy 24.6%.
CONCLUSION
FLIP chemotherapy was comparable to other combination chemotherapy for advanced non-small cell lung cancer with moderate toxicities.
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Treatment of Advanced Gastric Cancer with Oral UFT and Leucovorin
Seong Kyoon Cheong, Ki Chan Kim, Yeul Hong Kim, Sang Won Shin, Jun Suk Kim
J Korean Cancer Assoc. 1994;26(3):369-377.
AbstractAbstract PDF
We conducted a phase II trial of oral administration of UFT and leucovorin in patients with advanced gastric adenocarcinoma. Sixteen patients entered on this study from September 1992 to November 1993. The treatment regiman consisted of oral administration of UFT (480 mg/m/day), and leucovorin (25 mg/ m(2)/day) for 21 consecutive days. The dosage of UFT was adjusted after each treatment and the treatment was repeated every 4 weeks. The total number of administered treatments in 16 patients was 55 and the median number was 4. Among 14 evaluable patients, 1 patient (7.2%) had a complete response and 3 patients (30%) achieved paritial response resulting in an overall response rate of 28.5%. The median duration of response was 15 weeks (4+- 48+). The median survival time for all 16 patients was 24 weeks (4+- 48+). Gastrointestinal toxicity was common and toxicity over grade 3 included diarrhea in 7 patients (43.8%), mucositis in 2 patients (12.5%) and anorexia, nausea and vomiting in 1 patient respectively. Grade 1 leukopenia was observed in 3 patients (18.8%). In conclusion, oral administration of UFT and leucovorin in patients with advanced gastric cancer who have poor general condition seems to be comparable to ther chemotherapy regi- mens in efficacy and toxicity.
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Leucovorin , 5-Fluorouracil and Cisplatin ( LV - FP ) Chemotherapy for Advanced Colorectal Cancer
Young Jin Yuh, Young Hyuck Im, Yoon Koo Kang, Bong Seog Kim, Hyung Gun Kim, Tae Yong Son, Sang Goo Lee, Eun Mee Cheon, You Cheoul Kim, Chang Min Kim, Weon Seon Hong, Jhin Oh Lee, Tae Woong Kang
J Korean Cancer Assoc. 1995;27(1):44-52.
AbstractAbstract PDF
The biochemical modulation of 5-fluorouracil(5-FU) by leucovorin has been demonstrated to enhance the activity of 5-FU in patients with advanced colorectal cancer and the synergism between 5-FU and cisplatin is well known in advanced gastrointestinal tract cancers. We conducted a phase II trial to evaluate the effect of a combination of leucovorin, 5-FU, and cisplatin(LV-FP) in patients with advanced colorectal cancer. LV-FP regimen consisted of leu- covorin 20 mg/m/day IV in day 1-5, 5-FU 1,000 mg/m/day continuous IV. infusion in day 1-5, and cisplatin 20 mg/m/day IV in day 1-5. The regimen was repeated every 3 weeks. Among 46 patients with histologically confirmed advanced colorectal adenocarcinoma, 31 patients had measurable lesion(s) with median age of 55 years(22-70 years). 27 patients had previous histo- ry of chemotherapy and l9 were previously untreated. There was no complete respanse. 11 patients responded partially to the regimen to make the response rate 35%(l1/31). The median time to progression was 16 weeks (2-44 weeks), and the median survival time was 42 weeks(l+~80 weeks). There was no difference in response rates between the previously treated and the previously untreated. Hematologic toxicities were mild and non-hematologic toxicities were also tolerable. There was no treatment-related mortality. These results indicate that the LV-FP regimen is safe and effective in advanced colorectal adenocarcinoma.
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Expression and Significance of c-erbB-2 in Radically Resected Colorectal Cancer
Hyun Cheol Chung, Sun Young Rha, Joon Oh Park, Seung Hun Song, Jae Yong Cho, Jung Bae Aha, Hye Ran Lee, Chong In Lee, Nae Choon Yoo, Joo Hang Kim, Jae Kyung Roh, Jin Sil Seong, Gwi Eon Kim, Jin Sik M
J Korean Cancer Assoc. 1995;27(3):389-403.
AbstractAbstract PDF
Overexpression of c-erbB-2 oncoprotein has been shown to correlate with poor prognosis and drug-resistance to the conventional chemotherapy with 5-fluorouracil in breast and gastric cancers. To evaluate the clinical significance of c-erbB-2 overexpreseion in colorectal cancer, immunohistochemical staining was performed with the paraffin-embedded tiasues of 141 colorectal cancer patients with curative surgery. The follow-up duration ranged from 7 to 61 months(median 30 months). Two-year disease- free and overall survival rate of the total patients were 77%, 91%, respectively. The c-erbB-2 positive rate was 24.8%, Even if patients with c-erbB-2 overexpression showed a tendency of poor prognosis than c-erbB-2 negative patients, T-factor and the TNM stage were independent prognostic factors in multivariate analysis. In subset analysis with c-erbB-2 negative patienta, there were no differences in recurrence rate and 2-year disease-free survival rate between pa- tients with chemotherapy and without chemotherapy(20.0% versus 26.1%)(80.0% versus 82.0%). However, in c-erbB-2 positive patients, those subgroup with chemotherapy showed tendencies toward advantages in relapse rate and 2-year disease-free survival rate than those of subgroup without chemotherapy(21.0% versus 50.0%; p=0.09)(76.0% versus 50.0%: p=0.06). Also, there was a tendency of increased time to relapse in patients with chemotherapy comparing to that of the patients without chemotherapy(7.5 months versus l7.0 months; p = 0.09). In stage III, patients with c-erbB-2 overexpression showed increased 2-year disease-free survival rate with chemotherapy as comparing to that of patients without chemotherapy(81.0% versus 29.0%; p= 0.003). Again, this survival benefit was not found in c-erbB-2 negative stage III patients regard- less of chemotherapy. In conclusion, c-erbB-2 overexyression might be a marker of relative drug resistance to 5-FU which will be converted with the high dose treatment of modulation with leucovorin. A prospective randomized trial is warrented to confirm this suggestion and for the clinical applica- tion of c-erbB-2 overexpression.
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Adjuvant Chemotherapy with ' 5-Fluorouracil Plus Low - dose Leucovorin Following Surgical Resection of Stage 2 , 3 Colon Cancer
Je Hwan Lee, Tae Won Kim, Jong Soo Choi, Dai Young Zang, Ho Young Pyun, Sung Bae Kim, Sang We Kim, Cheol Won Suh, Kyoo Hyung Lee, Jung Shin Lee, Woo Kun Kim, Sang Hee Kim, Jin Cheon Kim, Suk Koo Kim
J Korean Cancer Assoc. 1995;27(5):846-857.
AbstractAbstract PDF
Obtivea: About seventy-five percent of the individuals with colon cancer will have a primary surgical resection with the hope of complete tumor eradication. Despite the high resectability rate and a general improvement in therapy, nearly half of all patients with colon cancer still die of metastatic tumor. Over the past three decades, many clinical studies have failed to demonstrate benefits from adjuvant therapy. Recently, new data from several studies have demonstrated delays in tumor recurrence and increases in survival for specific groups of patients. The objective of this study was to evaluate the effective- ness of 5-fluorouracil(5-FU) and low-dose leucovorin in reducing the recurrence rate and improving the survival of the patients with surgically resected colon cancer in stage II and III. Methods: One hundred and fifty six with surgically resected colon cancer in stage II and 1II from Nov 1989 to Dec 1993 were included in this study and were divided into two groups. First group(LF arm) included eighty five Patients who received combination chemotherapy of '5-FU and low-dose 1eucovorin' following resection of colon cancer, and second group(control arm) included seventy one patients who received only oral UFT or no adjuvant treatment. '5-FU and low-dose leucovorin' chemotherapy consisted of leucovorin 20 mg/m(2), intravenously, plus 5-FU 400 mg/m(2), intravenously, on days 1-5 every 4 weeks for 6 cycles. Results: I) There were significantly more recurrences and distant failure in control arm than LF arm. 2) The estimated 4-year disease-free survival was 82.5% in LF arm and 59.8% in control arm(p = 0.007). 3) The estimated 4-year overall survival was 94.3% in LF arm and 63.9% in control arm (p = 0.001). 4) The survival differences between LF arm and control arm were significant in stage II and III respectively. 5) Number of metastatic lymph nodes, histologic differentiation, and whether or not pa- tients received 5-FU/leucovorin chemotherapy, were each found to have prognostic significance. Concluslon: This study strongly suggests that 5-FU and low-dose leucovorin adjuvant chemotherapy is effective in patients with surgically resected stage II and III colon cancer.
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5-Fluorouracil , Leucovorin and Mitomycin C ( MLF ) Chemotherapy for Advanced Gastric Cancer : Results of A Phase 2 Trial
Sung Hyun Yang, Sung Rok Kim, Eun Soo Yang, Jong Cheol Ryu, Joon Hee Kim, Chul Soo Kim, Re Hwe Kim
J Korean Cancer Assoc. 1996;28(2):191-198.
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The results of systemic chemotherapy for advanced stomach cancer are still disappointing despite of numerous studies which has been performed to develop better treatment regimens. Mitomycin C (MMC) is one of the most active agents against stomach cancer and leucovorin (LV) enhance cytotoxicity of 5-fluorouracil (5-FU). This clinical phase II trial was designed to evaluate the efficacy of combination chemotherapy with MMC and LV-modulated 5-FU (MLF). Thirty nine patients were entered into the trial. All patients had measurable lesion. The MLF reaimen consisted of 5-FU 375 mg/§³ IV days 1 through 5: LV 20 mg/§³ IV just before 5-FU infusion days 1 through 5; and MMC 9 mg/§³ IV day l (7mg/§³ from the 2nd cycle). Cycles were repeated every 4 weeks. There were 19 responses (48%) including 6 clinical complete responses. The median survival of all 39 patients was 40.4 weeks. There was minimal myelosuppression; grade 3-4 leucopenia or thrombocytopenia in 26% of cycles. Non-hematologic toxicities were also tolerable; grade 3 nausea or vomiting in 8% of patients. This phase II study showed that the MLF therepy is comparable in effect for advanced stomach cancer with minimal toxicities, deserving phase III study with other regimens.
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