Meropol N J, Noel D, Sonnichsen D S, Birkhofer M J
Division of Medicine, Roswell Park Cancer Institute, Buffalo, New York, USA.
Oncology (Williston Park). 1997 Sep;11(9 Suppl 10):22-5.
Therapeutic options for patients with advanced colorectal cancer who have failed treatment with fluorouracil (5-FU) are limited. Responses have been reported in this setting with a protracted venous infusion of 5-FU. Daily oral therapy with tegafur and uracil (UFT) plus leucovorin (LV) has the potential to mimic the pharmacology of continuous infusion 5-FU. Therefore, we undertook a phase II study of a 28-day schedule of a combination chemotherapy regimen containing oral UFT/leucovorin in patients with measurable metastatic colorectal cancer who had failed treatment with bolus 5-FU. In addition, we sought to determine whether coadministration of UFT and leucovorin alters the bioavailability of these agents. In a pretreatment phase, each patient underwent sequential pharmacokinetic sampling following a single dose of UFT alone, leucovorin alone, and the combination of UFT plus leucovorin. The preliminary results of this trial suggest that tegafur pharmacokinetics are not affected by coadministration of leucovorin and that folate pharmacokinetics are not affected by UFT.
对于氟尿嘧啶(5-FU)治疗失败的晚期结直肠癌患者,治疗选择有限。在这种情况下,已有关于延长5-FU静脉输注的反应报道。替加氟与尿嘧啶(UFT)联合亚叶酸钙(LV)的每日口服疗法有可能模拟持续输注5-FU的药理学作用。因此,我们对接受大剂量5-FU治疗失败且有可测量转移性结直肠癌的患者进行了一项II期研究,该研究采用含口服UFT/亚叶酸钙的联合化疗方案,疗程为28天。此外,我们试图确定UFT与亚叶酸钙联合给药是否会改变这些药物的生物利用度。在预处理阶段,每位患者在单剂量单独使用UFT、单独使用亚叶酸钙以及UFT加亚叶酸钙联合用药后进行序贯药代动力学采样。该试验的初步结果表明,亚叶酸钙联合给药不影响替加氟的药代动力学,UFT也不影响叶酸的药代动力学。