Oxaliplatin/fluorouracil/leucovorin in advanced colorectal carcinoma: an asian experience

Oxaliplatin/fluorouracil/leucovorin (FOLFOX4) is an effective and generally well-tolerated regimen in Western studies of metastatic colorectal carcinoma.

To evaluate the objective tumor responses and toxicities of the FOLFOX4 regimen in a predominantly Chinese population with advanced colorectal carcinoma in Singapore.

Forty-seven consecutive patients were enrolled in a retrospective study between March 1998 and December 2001. FOLFOX4 was first-line treatment in 36% of these patients, second-line in 36%, third-line in 17%, and fourth-line in 11%. Tumor responses were assessed radiologically, and toxicities were graded by the National Cancer Institute common toxicity system.

The objective response rate (all partial responses) was 45%, and stable disease was achieved in 35% of the patients. There were no deaths due to toxicity. Mild to moderate peripheral sensory neuropathy affected half of the patients, with 1 report of cold exacerbation in this tropical series. The rate of hypersensitivity reactions to oxaliplatin was 11%, and they usually occurred late in the treatment course.

FOLFOX4 has good efficacy in metastatic colorectal carcinoma in our local population, but the rate of hypersensitivity reactions to oxaliplatin was high.