Two-week combination chemotherapy with gemcitabine, high-dose folinic acid and 5 fluorouracil (GEMFUFOL) as first-line treatment of metastatic biliary tract cancers.

Abstract

BACKGROUND:

The aim of this study was to evaluate the efficacy and tolerability of a gemcitabine, 5-fluorouracil and leucovorin (GEMFUFOL) chemotherapy regimen as first line treatment of metastatic biliary tract cancer.

MATERIALS AND METHODS:

All patients received folinic acid 400 mg/m(2) on day 1, 5-fluorouracil bolus 400 mg/ m2 on day 1, IV infusion of 5-fluorouracil 2400 mg/m(2) over 46 hours, and gemcitabine 1250 mg/m(2) on day 1.

RESULTS:

A total of 29 patients with metastatic biliary tract cancer received GEMFUFOL regimen as the first- line treatment. The mean follow-up was 22.1 months (95%CI, 12.5-31.8). One patient (3.4%) achieved complete response, 5 (17.2%) had partial response, and 4 (13.8%) had stable disease. The median progression-free survival was 3.3 months (95%CI, 2.9-3.7), and the median overall survival was 8.8 months (95%CI, 3.5-14). The 1-year and 2-year survival rates were 58.6% and 30%, respectively. Grade 3 and 4 toxicity included neutropenia in 4 patients (13.7%), thrombocytopenia in 2 (6.8%), anemia in 2 (6.8%), and alopecia in 1 (3.4%). Two patients (6.8%) developed febrile neutropenia. A dose reduction was achieved in 8 patients (27.6%) while 5 patients had extended-interval dosage (17.2%) for toxicity.

CONCLUSIONS:

The GEMFUFOL chemotherapy regimen was generally efficacious and tolerable as a first-line treatment of metastatic biliary tract cancer.

• Authors: Olcun Umit Unal, Ilhan Oztop, Ilkay Tugba Unek, Ahmet Ugur Yilmaz
• Journal: Asian Pacific journal of cancer prevention : APJCP (Asian Pac J Cancer Prev) Vol. 14 Issue 9 Pg. 5263-7 ( 2013) ISSN: 2476-762X [Electronic] Thailand
• PMID: 24175811 (Publication Type: Journal Article)

Chemical References

• Deoxycytidine
• Leucovorin
• Fluorouracil
• Gemcitabine

Topics

• Adenocarcinoma (drug therapy, mortality, secondary)
• Adult
• Aged
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Biliary Tract Neoplasms (drug therapy, mortality, pathology)
• Deoxycytidine (administration & dosage, analogs & derivatives)
• Female
• Fluorouracil (administration & dosage)
• Follow-Up Studies
• Humans
• Infusions, Intravenous
• Leucovorin (administration & dosage)
• Male
• Middle Aged
• Neoplasm Metastasis
• Neoplasm Staging
• Prognosis
• Retrospective Studies
• Survival Rate
• Gemcitabine