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Treating metastatic colorectal cancer (mCRC) with prolonged infusions of 5-fluorouracil (5-FU) has been proven safer and possibly more effective than bolus regimens. However, the therapy requires central venous access and expensive infusion pumps. Researchers from the University of Texas M. D. Anderson Cancer Center in Houston have found that oral fluoropyrimidines can facilitate longer exposure to 5-FU and reduce inconvenience.
Previous studies established that a regimen of tegafur-uracil (UFT) and leucovorin (LV) administered 3 times a day offered comparable outcomes to bolus 5-FU/LV. Hoff et al decided to test a twice-daily regimen of UFT/LV in a double-blind phase II study that included 98 patients with mCRC. Half received a twice-daily regimen and half received a thrice-daily regimen. Median time to progression, overall response rate, and median overall survival appeared similar between the 2 dosing frequencies.
Researchers noted a higher incidence of grade 3 or 4 toxicities (30%) in the bid treatment group compared with the tid treatment group (30% vs 21%, respectively). They concluded, however, that twice-daily administration of UFT/LV constituted a rational, less-frequent dosing schedule overall for patients with mCRC and did not result in significantly different outcomes compared with thrice-daily dosing.
Hoff PM, Kopetz S, Thomas MB, et al. A phase II study of UFT with leucovorin administered as a twice daily schedule in the treatment of patients with metastatic colorectal cancer.
Br J Cancer. 2008;99(5):722-726.