CPT-11 (irinotecan) addition to bimonthly, high-dose leucovorin and bolus and continuous-infusion 5-fluorouracil (FOLFIRI) for pretreated metastatic colorectal cancer
CPT-11 (irinotecan) addition to bimonthly, high-dose leucovorin and bolus and continuous-infusion 5-fluorouracil (FOLFIRI) for pretreated metastatic colorectal cancer
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DOI：
10.1016/s0959-8049(99)00150-1
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发表时间：
1999-09-01
影响因子：
8.4
通讯作者：
de Gramont, A
中科院分区：
文献类型：
--
作者：
André, T;Louvet, C;de Gramont, A
CPT-11（伊立替康）在对甲酰四氢叶酸（LV）和5-氟尿嘧啶（5-FU）耐药的晚期结直肠癌患者中显示出活性。在这项研究中，简化的LV-5-FU双月方案联合CPT-11（FOLFIRI）作为晚期结直肠癌患者的三线治疗。使用一次性泵持续输注5-FU作为门诊治疗。FOLFIRI包括CPT-11 180 mg/m2，第1天输注90分钟; CPT-11期间LV 400 mg/m2，输注2小时，随后立即推注5-FU 400 mg/m2，持续输注46小时，剂量为2.4-3 g/m2，每2周一次。在接受治疗的33名患者中，2名患者部分缓解，总缓解率为6%; 20名患者稳定（61%），11名患者疾病进展（33%）。从FOLFIRI开始，中位无进展生存期为18周，中位生存期为43周。对于分析的242个周期，每例患者的NCI-CTC 3-4级毒性为恶心15%、腹泻12%和中性粒细胞减少症15%。总体而言，10例患者（30%）发生了3-4级毒性。7例患者（21%）有2级脱发。FOLFIRI在接受过大量预治疗的患者中产生活性和可接受的毒性，这些患者伴有有限的腹泻、大多数无症状的中性粒细胞减少和可管理的恶心和相对罕见的脱发。该方案适用于化疗初治患者的研究。(C)1999 Elsevier Science Ltd.保留所有权利。
CPT-11 (irinotecan) has shown activity in patients with advanced colorectal cancer resistant to leucovorin (LV) and 5-fluorouracil (5-FU). In this study, the simplified bimonthly LV-5-FU regimen was combined with CPT-11 (FOLFIRI) as third-line therapy for patients with advanced colorectal cancer. Continuous infusion of 5-FU was administered with disposable pumps as outpatient therapy. FOLFIRI consisted of CPT-11 180 mg/m(2) as a 90-min infusion day 1; LV 400 mg/m(2) as a 2-h infusion during CPT-11, immediately followed by 5-FU bolus 400 mg/m(2) and 46-h continuous infusion of 2.4-3 g/m(2) every 2 weeks. Among the 33 patients treated, 2 had partial responses for an overall response rate of 6%; 20 patients were stabilised (61%) and 11 had disease progression (33%). From the start of FOLFIRI, median progression-free survival was 18 weeks and median survival was 43 weeks. For the 242 cycles analysed, NCI-CTC toxicities grade 3-4 per patient were nausea 15%, diarrhoea 12% and neutropenia 15%. Overall, 10 patients (30%) experienced grade 3-4 toxicity. 7 patients (21%) had grade 2 alopecia. FOLFIRI generated activity and acceptable toxicity, in heavily pretreated patients, with limited diarrhoea, mostly asymptomatic neutropenia and manageable nausea and relatively uncommon alopecia. This regimen is suitable for studies in chemotherapy-naive patients. (C) 1999 Elsevier Science Ltd. All rights reserved.