Περίληψη:
In the present study, we evaluated the efficacy and safety of the weekly
combination of etoposide, leucovorin (LV) and 5-fluorouracil (5-FU) when
administered as second-line chemotherapy in patients with
relapsed/refractory advanced colorectal cancer (ACC), previously treated
with weekly LV+5-FU. Etoposide was administered at 3 different dose
levels (DLs), in 3 groups of 20 patients each (total: 60); DL-I:
etoposide 80 mg/m(2), DL-II: etoposide 120 mg/m(2), and DL-III:
etoposide 180 mg/m(2), in 45 min i.v. infusion, and followed in all
levels by LV 100 mg/m(2) i.V. over 1 hour and 5-FU 500 mg/m(2) i.v.
bolus. Treatment was administered weekly until disease progression or
unacceptable toxicity. No patients at DL-I responded, while 2 patients
at DL-II and 3 at DL-III had a partial response (PR). Stable disease
(SD) rates were as follows; at DL-I: 2, DL-II: 8 and DL-III: 9. More
patients in DL-I progressed (n=19) compared to DL-II (n=10) and DL-III
(n=8) (p<0.0007). Time to progression was for DL-I, -II, -III: 17, 15,
and 14 weeks, respectively. Median survival was DL-I, -II, -III: 30, 30,
and 32.5 weeks, respectively. Toxicity consisted mainly of neutropenia,
diarrhea and mucositis at all DLs, and was significantly more severe in
DL-III. No difference was noted in responses between DL-II and DL-III.
The authors conclude that the combination of etoposide with LV+5-FU has
limited activity when administered after failure of weekly LV+5-FU in
patients with ACC and should not be recommended for further evaluation.
Συγγραφείς:
Tsavaris, N
Kosmas, C
Gennatas, K
Vadiaka, M
Skopelitis,
E
Xila, V
Rokana, S
Margaris, E
Zografos, G and
Papastratis, G
Kouraklis, G
