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A comprehensive review of 5‐fluorouracil and leucovorin in patients with metastatic colorectal carcinoma
Author(s) -
Machover David
Publication year - 1997
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/(sici)1097-0142(19971001)80:7<1179::aid-cncr1>3.0.co;2-g
Subject(s) - medicine , fluorouracil , colorectal cancer , metastatic carcinoma , oncology , carcinoma , general surgery , chemotherapy , cancer
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. Cancer 1997; 80:1179‐87. © 1997 American Cancer Society.