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Related Experiment Videos

[Levofolinate and fluorouracil combination therapy].

S Takeuchi1, M Murakami

  • 1Nagoya Branch Oncology Group, Wyeth Lederle (Japan), 2-2-13 Nishiki, Naka-ku, Nagoya 460-0003, Japan. takeucs2@wai.wyeth.com

Nihon Yakurigaku Zasshi. Folia Pharmacologica Japonica
|October 2, 2001
PubMed
Summary
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The Journal of clinical endocrinology and metabolism·1992
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The combination of levofolinate (l-leucovorin) and 5-fluorouracil is an effective chemotherapy regimen for advanced gastrointestinal and colorectal cancers. Careful patient selection and monitoring are essential due to potential adverse events like diarrhea and leukocytopenia.

Area of Science:

  • Oncology
  • Pharmacology
  • Gastrointestinal Cancer Treatment

Context:

  • The d,l-leucovorin and 5-fluorouracil (5FU) regimen is a standard treatment for colorectal cancer in the USA and Europe.
  • In Japan, clinical trials demonstrated the efficacy of the l-leucovorin (l-LV) and 5FU combination for advanced gastrointestinal cancers, leading to its approval in 1999.

Purpose:

  • To evaluate the efficacy and safety of the l-leucovorin and 5-fluorouracil regimen for advanced gastric and colorectal cancers.
  • To establish optimal dosage and administration schedules for the l-LV and 5FU regimen, referencing the RPMI weekly method.

Summary:

  • The l-leucovorin and 5-fluorouracil regimen, a biochemical modulation of 5FU, has shown comparable efficacy to d,l-leucovorin regimens in Japanese patients with advanced gastrointestinal and colorectal cancers.

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  • Recent studies suggest enhanced antitumor activity and progression-free survival with combinations of irinotecan or oxaliplatin plus l-leucovorin and 5FU, though these are not yet fully established.
  • Diarrhea and leukocytopenia (grade 3 or higher) are identified as major adverse events, necessitating careful patient monitoring and selection.

    • Impact:

    • The l-leucovorin and 5-fluorouracil regimen is an approved and utilized treatment option for advanced gastric and colorectal cancers in Japan.
    • Ongoing research into combination therapies with irinotecan or oxaliplatin aims to further improve outcomes for gastrointestinal cancer patients.
    • The findings underscore the importance of vigilant monitoring for adverse events to ensure patient safety during chemotherapy.