Prostaglandins and chemotherapy-induced ulcers in dogs

About 50% of patients receiving intrahepatic infusion of 5-fluorouracil deoxyriboside (5-FUDR) for colorectal cancer with hepatic metastasis develop significant gastroduodenal lesions. This paper reviews two studies on the effect of 16,16 dimethyl prostaglandin E2 (DMPGE2) on 5-fluorouracil-induced mucosal lesions in dogs. DMPGE2 at high doses (2 micrograms X kg-1 X h-1), which reduced histamine-stimulated gastric acid secretion by 65%, reduced gastric mucosal injury. Interestingly, DMPGE2 at much lower doses (0.02 micrograms X kg-1 X h-1), which had no effect on histamine-stimulated gastric acid secretion, was also effective in lowering gastric mucosal injury. These animal studies, if supported by the results of a larger patient study, would provide a rational basis for the use of prostaglandins in the prophylaxis and treatment of chemotherapy-induced ulcers.