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Which 5-fluorouracil regimen?--the great debate
M Vincent1, R Labianca, P Harper
1London Regional Cancer Centre, Department of Medical Oncology, University of Western Ontario, Canada. mvincent@lrcc.on.ca
Anti-Cancer Drugs
|June 23, 1999
Summary
5-Fluorouracil (5-FU) is a long-standing colorectal cancer treatment, but its optimal use and toxicity remain challenges. Future treatment likely involves novel combinations rather than solely experimenting with 5-FU and leucovorin (LV) regimens.
Area of Science:
- Oncology
- Pharmacology
Background:
- 5-Fluorouracil (5-FU) has been a cornerstone in treating advanced colorectal cancer for over four decades.
- Despite extensive research and varied administration methods, optimal 5-FU regimens and managing its toxicity remain significant clinical challenges.
Purpose of the Study:
- To review clinical trials of 5-Fluorouracil (5-FU) in advanced colorectal cancer.
- To discuss the evolving role of 5-FU in light of new chemotherapeutic agents and treatment strategies.
Main Methods:
- Review of clinical trials involving 5-Fluorouracil (5-FU) alone and in combination with modulating agents like leucovorin (LV).
- Analysis of different administration schedules, including bolus injection and intravenous infusion.
Main Results:
- Optimal treatment regimens for advanced colorectal cancer using 5-FU remain unclear, with significant international practice variations.
- 5-FU toxicity presents a barrier to achieving maximal clinical benefit for many patients.
Conclusions:
- The future of advanced colorectal cancer treatment lies in combining novel and established agents for improved outcomes.
- Continued experimentation with various 5-FU and leucovorin (LV) schedules is less promising than exploring synergistic combination therapies.