Abstract | PURPOSE: EXPERIMENTAL DESIGN: One hundred fifteen patients including 72 men (median age, 63 years; range, 36-79 years) and 43 women (median age, 60 years; range, 36-73 years) received 6 cycles of l- leucovorin 100 mg/m(2)/day and 5-FU 370 mg/m(2)/day i.v. boluses (5 days every 4 weeks). Individual plasma concentrations of 5-FU and 5-FDHU were determined on day 1 of the first cycle with a validated high performance liquid chromatography method, and the main pharmacokinetic variables were determined. Follow-up of all patients was extended up to 5 years after the end of adjuvant chemotherapy, and DFS was recorded. Univariate and multivariate analyses were conducted to evaluate any correlation among 5-FU pharmacokinetics, clinical and pathologic variables, and DFS. RESULTS: The area under the time/concentration curve (AUC) of 5-FU was significantly lower in 58 subjects who recurred (7.5 +/- 2.9 h x mg/L) with respect to other patients (9.3 +/- 4.1 h x mg/L). Furthermore, AUC values lower than 8.4 h x mg/L together with lymph node involvement and the interruption of treatment or reduction of doses were identified as risk factors at univariate analysis. The completion of 6 cycles of adjuvant treatment without dosage modifications was the only independent risk factor at multivariate analysis, despite a trend toward significance for 5-FU AUC values (cutoff value, 8.4 hxmg/L) was observed (P = 0.06). CONCLUSIONS: Pharmacokinetics of 5-FU should be regarded as an important factor for predicting disease recurrence in colorectal cancers.
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Authors | Antonello Di Paolo, Monica Lencioni, Federica Amatori, Samantha Di Donato, Guido Bocci, Cinzia Orlandini, Marianna Lastella, Francesca Federici, Mauro Iannopollo, Alfredo Falcone, Sergio Ricci, Mario Del Tacca, Romano Danesi |
Journal | Clinical cancer research : an official journal of the American Association for Cancer Research
(Clin Cancer Res)
Vol. 14
Issue 9
Pg. 2749-55
(May 01 2008)
ISSN: 1078-0432 [Print] United States |
PMID | 18451241
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Antimetabolites, Antineoplastic
- 5-fluorodihydrouracil
- Leucovorin
- Fluorouracil
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Topics |
- Adult
- Aged
- Analysis of Variance
- Antimetabolites, Antineoplastic
(administration & dosage, pharmacokinetics, therapeutic use)
- Chemotherapy, Adjuvant
- Colorectal Neoplasms
(drug therapy)
- Disease-Free Survival
- Female
- Fluorouracil
(administration & dosage, analogs & derivatives, pharmacokinetics, therapeutic use)
- Humans
- Leucovorin
(administration & dosage, therapeutic use)
- Male
- Middle Aged
- Multivariate Analysis
- Retrospective Studies
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