Oxaliplatin in Combination with Infusional 5-Fluorouracil and Leucovorin Every 2 Weeks as First-Line Treatment in Patients with Advanced Colorectal Cancer: A Phase II Study

Abstract

Purpose: To evaluate the efficacy and safety of oxaliplatin (L-OHP) in combination with leucovorin (LV)-modulated bolus plus infusional 5-fluorouracil (5-FU; de Gramont schedule) every 2 weeks in chemotherapy-naive patients with advanced colorectal cancer (CRC). Patients and Methods: Thirty-two patients (median age: 69 years) with histologically confirmed and two-dimensionally measurable metastatic CRC were enrolled. The patients’ performance status (WHO) was 0 in 14 (44%), 1 in 15 (47%), and 2 in 3 (9%) patients. Twenty (62.5%) patients had at least two metastatic sites. LV was administered at a dose of 200 mg/m²/day as a 2-hour intravenous infusion, followed by 5-FU as an intravenous bolus at the dose of 400 mg/m² and then, as a 22-hour continuous infusion at the dose of 600 mg/m²/day for 2 consecutive days. L-OHP was administered on day 1 at the dose of 85 mg/m² as a 2-hour infusion in parallel with LV but using different infusion lines. Treatment was administered every 2 weeks. Results: In an intention-to-treat analysis, 2 (6.2%) complete and 9 (28%) partial responses (28%; odds ratio 34.2%; 95% confidence interval 17.92–50.83%) were achieved while 8 (25%) patients had stable disease and 13 (41%) progressive disease. The median duration of response was 5 months, but the median time to progression has not yet been reached. After a median follow-up period of 11 months, the median survival has not yet been attained, but the projected probability for 1-year survival was 72%. Grade 3/4 neutropenia occurred in 16 (50%) patients while 1 (3%) of them developed febrile neutropenia. There was no treatment-related death. Peripheral neuropathy grade 2 and ≧3 occurred in 5 (16%) and 7 (21%) patients, respectively. Conclusions: The bimonthly administration of L-OHP in association with LV-modulated bolus plus infusional 5-FU (‘de Gramont’ regimen) is a well-tolerated and effective front-line treatment for metastatic CRC.