[A case of irinotecan-resistant colon cancer responding to chronotherapy with oxaliplatin, 5-FU, l-LV].

Abstract

We report a case of irinotecan-resistant colon cancer responding to chronotherapy with oxaliplatin (L-OHP), 5-FU, l-LV (l-Leucovorin). A 72-year-old man was examined at a certain hospital because of constipation and appetite loss. Chest computed tomography (CT) revealed lung metastases, and abdominal CT revealed liver metastases. He was then referred to our hospital. A colonoscopy revealed type 2 tumor in the colon, at the hepatic flexure. We diagnosed adenocarcinoma of the colon with metastases to the liver and lung. Resection of the primary lesion was performed, and chemotherapy consisting of systemic administration of CPT-11, 5-FU and l-LV was performed. After 2 courses of combined treatment with CPT-11/5-FU/l-LV, CT revealed considerable reduction of the metastatic tumors. However, after 3 courses of combined treatment, progressive disease was observed and new brain and bone metastases were detected. We imported and used a non-approved/pending drug, oxaliplatin from the Remedy and Health Corporation, with informed consent from the patient and his family and our clinical ethics committee. Chronotherapeutic schedules have been performed, from which the safety and activity of oxaliplatin against advanced colorectal cancer was reported. Our patient received a 5-day course of chronomodulated 5-FU and l-LV (750 and 300 mg/body/day, respectively; peak delivery rate at AM 4:00 hours) with L-OHP on the first day of each course (100 mg/body, as a 6-hour infusion). Each course was again repeated every 21 days. A partial response was observed in the liver and lung metastases. These results indicate that chronomodulated 5-FU and LV with L-OHP therapy could be an effective regimen for cases of irinotecan-resistant colon cancer.

• Authors: Tamotsu Sagawa, Yasushi Tsuji, Norihiro Takayanagi, Yasuo Hirayama, Sumio Sakamaki, Hiroki Chiba, Satoshi Iyama, Takatomi Oku, Yasushi Sato, Minoru Takahashi, Tetsuji Takayama, Yoshiro Niitsu
• Journal: Gan to kagaku ryoho. Cancer & chemotherapy (Gan To Kagaku Ryoho) Vol. 30 Issue 4 Pg. 537-43 (Apr 2003) ISSN: 0385-0684 [Print] Japan
• PMID: 12722689 (Publication Type: Case Reports, Journal Article)

Chemical References

• Organoplatinum Compounds
• Oxaliplatin
• Irinotecan
• Leucovorin
• Fluorouracil
• Camptothecin

Topics

• Aged
• Antineoplastic Combined Chemotherapy Protocols (administration & dosage)
• Bone Neoplasms (secondary)
• Camptothecin (analogs & derivatives, pharmacology)
• Chronotherapy
• Colonic Neoplasms (drug therapy, pathology)
• Drug Evaluation
• Drug Resistance, Neoplasm
• Fluorouracil (administration & dosage)
• Humans
• Irinotecan
• Leucovorin (administration & dosage)
• Liver Neoplasms (secondary)
• Lung Neoplasms (secondary)
• Male
• Organoplatinum Compounds (administration & dosage)
• Oxaliplatin