Phase I study of CPT-11 and bolus 5-FU/l-leucovorin in patients with metastatic colorectal cancer

Hiromitsu Fujishima, Ikuo Kikuchi, Osamu Miyanaga, Akira Ueda, Eishi Baba, Kenji Mitsugi, Mine Harada, Shuji Nakano

Research output: Contribution to journalArticle

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Abstract

Background. Irinotecan (CPT-11) and bolus 5-fluorouracil (5-FU)/leucovorin (LV) administered weekly for 4 weeks every 42 days (Saltz regimen) is active but substantially toxic in patients with metastatic colorectal cancer (CRC). The efficacy and toxicity of this regimen, however, have not been determined in Japanese patients with metastatic CRC. Methods. We investigated the maximum tolerated dose (MTD), dose-limiting toxicity (DLT), and recommended phase II dose (RD) for CPT-11 given i.v. (90-min infusion) and bolus 5-FU plus biologically active l-LV administered weekly for 3 weeks every 28 days (modified Saltz regimen) in Japanese patients with metastatic CRC. Eighteen patients with measurable disease, Eastern Cooperative Oncology Group (ECOG) performance status of 2 or less, and adequate organ functions were enrolled. Results. At dose level 2 (CPT-11, 100 mg/m 2 ; 5-FU, 400 mg/m 2 ; and l-LV, 25 mg/body), 1 of 6 patients had DLT (febrile neutropenia). At dose level 3 (CPT-11, 100 mg/m 2 ; 5-FU, 500 mg/m 2 ; and l-LV, 25 mg/body), 2 of 6 patients had DLT (febrile neutropenia and grade 4 neutropenia lasting more than 4 days). To determine whether level 3 was the MTD level, an additional 3 patients were treated at this level, but no DLT was observed. Consequently, 2 of 9 patients had DLT at level 3, this level thus being considered as the RD. At this level, grade 3-4 neutropenia was common but manageable. Nonhematological toxicities were mild. Seven partial responses were observed in the 18 enrolled patients (response rate [RR], 39%), and 8 patients (44%) experienced stable disease. Conclusion. This CPT-11/5-FU/l-LV regimen administered weekly for 3 weeks every 28 days has substantial antitumor activity, with manageable toxicities. A multicenter phase II study is currently underway.

Original languageEnglish
Pages (from-to)92-97
Number of pages6
JournalInternational Journal of Clinical Oncology
Volume9
Issue number2
DOIs
Publication statusPublished - Apr 1 2004

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irinotecan
Leucovorin
Fluorouracil
Colorectal Neoplasms
Febrile Neutropenia
Maximum Tolerated Dose
Neutropenia

All Science Journal Classification (ASJC) codes

  • Surgery
  • Hematology
  • Oncology

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Phase I study of CPT-11 and bolus 5-FU/l-leucovorin in patients with metastatic colorectal cancer. / Fujishima, Hiromitsu; Kikuchi, Ikuo; Miyanaga, Osamu; Ueda, Akira; Baba, Eishi; Mitsugi, Kenji; Harada, Mine; Nakano, Shuji.

In: International Journal of Clinical Oncology, Vol. 9, No. 2, 01.04.2004, p. 92-97.

Research output: Contribution to journalArticle

Fujishima, Hiromitsu ; Kikuchi, Ikuo ; Miyanaga, Osamu ; Ueda, Akira ; Baba, Eishi ; Mitsugi, Kenji ; Harada, Mine ; Nakano, Shuji. / Phase I study of CPT-11 and bolus 5-FU/l-leucovorin in patients with metastatic colorectal cancer. In: International Journal of Clinical Oncology. 2004 ; Vol. 9, No. 2. pp. 92-97.
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abstract = "Background. Irinotecan (CPT-11) and bolus 5-fluorouracil (5-FU)/leucovorin (LV) administered weekly for 4 weeks every 42 days (Saltz regimen) is active but substantially toxic in patients with metastatic colorectal cancer (CRC). The efficacy and toxicity of this regimen, however, have not been determined in Japanese patients with metastatic CRC. Methods. We investigated the maximum tolerated dose (MTD), dose-limiting toxicity (DLT), and recommended phase II dose (RD) for CPT-11 given i.v. (90-min infusion) and bolus 5-FU plus biologically active l-LV administered weekly for 3 weeks every 28 days (modified Saltz regimen) in Japanese patients with metastatic CRC. Eighteen patients with measurable disease, Eastern Cooperative Oncology Group (ECOG) performance status of 2 or less, and adequate organ functions were enrolled. Results. At dose level 2 (CPT-11, 100 mg/m 2 ; 5-FU, 400 mg/m 2 ; and l-LV, 25 mg/body), 1 of 6 patients had DLT (febrile neutropenia). At dose level 3 (CPT-11, 100 mg/m 2 ; 5-FU, 500 mg/m 2 ; and l-LV, 25 mg/body), 2 of 6 patients had DLT (febrile neutropenia and grade 4 neutropenia lasting more than 4 days). To determine whether level 3 was the MTD level, an additional 3 patients were treated at this level, but no DLT was observed. Consequently, 2 of 9 patients had DLT at level 3, this level thus being considered as the RD. At this level, grade 3-4 neutropenia was common but manageable. Nonhematological toxicities were mild. Seven partial responses were observed in the 18 enrolled patients (response rate [RR], 39{\%}), and 8 patients (44{\%}) experienced stable disease. Conclusion. This CPT-11/5-FU/l-LV regimen administered weekly for 3 weeks every 28 days has substantial antitumor activity, with manageable toxicities. A multicenter phase II study is currently underway.",
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T1 - Phase I study of CPT-11 and bolus 5-FU/l-leucovorin in patients with metastatic colorectal cancer

AU - Fujishima, Hiromitsu

AU - Kikuchi, Ikuo

AU - Miyanaga, Osamu

AU - Ueda, Akira

AU - Baba, Eishi

AU - Mitsugi, Kenji

AU - Harada, Mine

AU - Nakano, Shuji

PY - 2004/4/1

Y1 - 2004/4/1

N2 - Background. Irinotecan (CPT-11) and bolus 5-fluorouracil (5-FU)/leucovorin (LV) administered weekly for 4 weeks every 42 days (Saltz regimen) is active but substantially toxic in patients with metastatic colorectal cancer (CRC). The efficacy and toxicity of this regimen, however, have not been determined in Japanese patients with metastatic CRC. Methods. We investigated the maximum tolerated dose (MTD), dose-limiting toxicity (DLT), and recommended phase II dose (RD) for CPT-11 given i.v. (90-min infusion) and bolus 5-FU plus biologically active l-LV administered weekly for 3 weeks every 28 days (modified Saltz regimen) in Japanese patients with metastatic CRC. Eighteen patients with measurable disease, Eastern Cooperative Oncology Group (ECOG) performance status of 2 or less, and adequate organ functions were enrolled. Results. At dose level 2 (CPT-11, 100 mg/m 2 ; 5-FU, 400 mg/m 2 ; and l-LV, 25 mg/body), 1 of 6 patients had DLT (febrile neutropenia). At dose level 3 (CPT-11, 100 mg/m 2 ; 5-FU, 500 mg/m 2 ; and l-LV, 25 mg/body), 2 of 6 patients had DLT (febrile neutropenia and grade 4 neutropenia lasting more than 4 days). To determine whether level 3 was the MTD level, an additional 3 patients were treated at this level, but no DLT was observed. Consequently, 2 of 9 patients had DLT at level 3, this level thus being considered as the RD. At this level, grade 3-4 neutropenia was common but manageable. Nonhematological toxicities were mild. Seven partial responses were observed in the 18 enrolled patients (response rate [RR], 39%), and 8 patients (44%) experienced stable disease. Conclusion. This CPT-11/5-FU/l-LV regimen administered weekly for 3 weeks every 28 days has substantial antitumor activity, with manageable toxicities. A multicenter phase II study is currently underway.

AB - Background. Irinotecan (CPT-11) and bolus 5-fluorouracil (5-FU)/leucovorin (LV) administered weekly for 4 weeks every 42 days (Saltz regimen) is active but substantially toxic in patients with metastatic colorectal cancer (CRC). The efficacy and toxicity of this regimen, however, have not been determined in Japanese patients with metastatic CRC. Methods. We investigated the maximum tolerated dose (MTD), dose-limiting toxicity (DLT), and recommended phase II dose (RD) for CPT-11 given i.v. (90-min infusion) and bolus 5-FU plus biologically active l-LV administered weekly for 3 weeks every 28 days (modified Saltz regimen) in Japanese patients with metastatic CRC. Eighteen patients with measurable disease, Eastern Cooperative Oncology Group (ECOG) performance status of 2 or less, and adequate organ functions were enrolled. Results. At dose level 2 (CPT-11, 100 mg/m 2 ; 5-FU, 400 mg/m 2 ; and l-LV, 25 mg/body), 1 of 6 patients had DLT (febrile neutropenia). At dose level 3 (CPT-11, 100 mg/m 2 ; 5-FU, 500 mg/m 2 ; and l-LV, 25 mg/body), 2 of 6 patients had DLT (febrile neutropenia and grade 4 neutropenia lasting more than 4 days). To determine whether level 3 was the MTD level, an additional 3 patients were treated at this level, but no DLT was observed. Consequently, 2 of 9 patients had DLT at level 3, this level thus being considered as the RD. At this level, grade 3-4 neutropenia was common but manageable. Nonhematological toxicities were mild. Seven partial responses were observed in the 18 enrolled patients (response rate [RR], 39%), and 8 patients (44%) experienced stable disease. Conclusion. This CPT-11/5-FU/l-LV regimen administered weekly for 3 weeks every 28 days has substantial antitumor activity, with manageable toxicities. A multicenter phase II study is currently underway.

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