Lack of efficacy of high-dose leucovorin and fluorouracil in patients with advanced pancreatic adenocarcinoma Journal Article
| Authors: | Crown, J.; Casper, E. S.; Botet, J.; Murray, P.; Kelsen, D. P. |
| Article Title: | Lack of efficacy of high-dose leucovorin and fluorouracil in patients with advanced pancreatic adenocarcinoma |
| Abstract: | Leucovorin potentiates the cytotoxicity of fluorouracil (5-FU) in experimental tumor systems and appears to enhance the effectiveness of 5-FU in patients with colon cancer. Twenty-two eligible patients (18 previously untreated) with advanced pancreatic adenocarcinoma were treated in a phase II trial of leucovorin 500 mg/m2/d for 6 days by continuous intravenous infusion with 5-FU 370 mg/m2/d by rapid intravenous injection on 5 consecutive days, beginning 24 hours after initiation of leucovorin infusion. Among the 20 assessable patients, there were no complete or partial regressions, although there was one minor response lasting 4 months. Three patients had stable disease for 5, 20, and 21 months, respectively. Median survival was 10 weeks. Toxicity was predominantly mucosal; stomatitis grade 2 or worse was seen in five patients, and diarrhea grade 2 or worse was seen in four. Hospitalization for toxicity was necessary in four previously untreated patients and three previously treated patients. The median WBC nadir was 4.6 (range, 1.4 to 9.6) × 103/μL, and the median platelet nadir was 147.0 (range, 69.0 to 240.0) × 103/μL. This combination of leucovorin and 5-FU did not demonstrate meaningful therapeutic activity in patients with adenocarcinoma of the pancreas and was associated with moderate to severe toxicity. It should not be considered a standard treatment for patients with this disease. © 1991 by American Society of Clinical Oncology. |
| Keywords: | survival; adult; controlled study; aged; major clinical study; fluorouracil; advanced cancer; pancreatic neoplasms; prospective studies; adenocarcinoma; phase 2 clinical trial; leukopenia; mucosa inflammation; antineoplastic combined chemotherapy protocols; drug administration schedule; folinic acid; pancreas adenocarcinoma; toxicity; leucovorin; intravenous drug administration; middle age; drug evaluation; human; male; female; priority journal; article; support, non-u.s. gov't; support, u.s. gov't, p.h.s. |
| Journal Title: | Journal of Clinical Oncology |
| Volume: | 9 |
| Issue: | 9 |
| ISSN: | 0732-183X |
| Publisher: | American Society of Clinical Oncology |
| Date Published: | 1991-09-01 |
| Start Page: | 1682 |
| End Page: | 1686 |
| Language: | English |
| DOI: | 10.1200/jco.1991.9.9.1682 |
| PUBMED: | 1875224 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Article -- Export Date: 27 September 2019 -- Source: Scopus |
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