Oral fluoropirimidine treatment of heavily pretreated advanced colorectal cancer patients

Introduction: The purpose of this study was to establish the feasibility and efficacy of oral fluoropirimidine monotherapy in the treatment of advanced CRC patients failing conventional 5-fluorouracil, irinotecan and oxaliplatin containing regimen.

Patients and methods: Between 28 March 2003 and 12 February 2004, 25 advanced CRC patients were treated with oral fluoropirimidine monotherapy. 16 (3-UFT /13-Xeloda group) patients who had passed their first staging examinations were evaluated. Patients received tegafur 300mg/m2/d, uracyl 672mg/m2/d and leucovorine 90mg/m2/d days 1 to 28 every 5 weeks in the UFT group and capecitabine 2,500mg/m2/d days 1 to 14 every 3 weeks in the Xeloda group.

Results: In the Xeloda group in 3/13 cases partial remission was achieved. The UFT group showed 1/3, the Xeloda group 5/13 stable disease. In the UFT group 2/3, in the Xeloda group 5/13 progressive disease was observed after the first response evaluation. There was no complete remission in the two groups. In the UFT group 2 patients out of 6 failed to continue therapy due to severe side effects (one gastric ulcer and one allergic reaction) during the very first cycle. Two patients out of 19 treated with Xeloda were not able to continue the first cycle because of severe side effects (one pectoral angina, one grade 4 nausea). In the follow-up of patients only one haematological toxicity occurred in the Xeloda group (anaemia manageable with transfusion). Apart from moderate nausea no other toxicities had been experienced.

Conclusion: In spite of the modest number of patients evaluated and taking in consideration the disappointing responsiveness of heavily pre-treated advanced CRC, the results are encouraging.