Clinical experience with leucovorin and 5-fluorouracil

Area of Science:

• Oncology
• Medical Research

Background:

• Metastatic colorectal cancer (mCRC) treatment often involves combination chemotherapy.
• Leucovorin (LV) and 5-fluorouracil (5-FU) are standard agents, but optimizing their administration for efficacy and reduced toxicity is crucial.

Purpose of the Study:

• To evaluate the toxicity and efficacy of two different administration schedules of leucovorin (LV) and 5-fluorouracil (5-FU) in patients with metastatic colorectal cancer.
• To compare intravenous LV with oral LV in combination with 5-FU.

Main Methods:

• Two trials were conducted: Trial 1 used intravenous LV with a constant 5-FU dose. Trial 2 used oral LV with escalating 5-FU doses.
• Patient response, survival rates, and toxicity profiles were assessed in both trials.

Main Results:

• Trial 1 showed objective responses in 36% and disease stabilization in 31% with median survival of 8-10 months.
• Trial 2 reported a 35% response rate and 35% stabilization, with a median survival of 14 months and 12-month survival of 56%.
• Toxicity was generally manageable, primarily gastrointestinal and constitutional symptoms.

Conclusions:

• Both intravenous and oral LV combined with 5-FU demonstrate efficacy in metastatic colorectal cancer.
• Oral LV with escalating 5-FU shows potential for improved survival outcomes and warrants further randomized trials.