A randomized study of combined 5-fluorouracil and plasma perfusion over protein A-sepharose in human advanced colorectal carcinoma.

Abstract

To evaluate the advantage with regard to toxicity, response rate, time to progression and survival of combination chemoimmunotherapy over single-agent chemotherapy in patients with metastatic colorectal carcinoma (CRC), 30 patients were randomized to receive a combination of 5-fluorouracil (5-FU) by continuous i.v. infusion and plasma perfusion (PP) over protein A-Sepharose (group A), or a combination of 5-FU and PP over sepharose (group B) or 5-FU alone (group C). 5-FU was given at 1,000 mg/m2/d on days 1-5 of a 4-weekly cycle until progression. Patients of groups A and B received bi-weekly on-line PPs until disease progression or for a maximum of 19 treatments. PP was well tolerated and no severe or life-threatening toxicity was observed. The response rates were 10% for the group A (1 PR), 0% for the group B and 20% for the group C (1 CR + 1 PR). The times to tumor progression for patients in groups A and C were 22 months, 12 and 11 months, respectively and the median survival times were 17 months, 10 months and 9 months. Although the time to progression and survival tended to be higher in patients treated with protein A. PP, these differences were not statistically significant. This is the first report of a randomized trial showing some therapeutic advantage in combining protein A. PP with 5-FU in CRC patients. Further randomized studies are required to demonstrate the real true value of this chemoimmunotherapeutic approach.

• Authors: A Faradji, A Bohbot, J Damonte, J P Arnaud, M L North, J Goetz, M L Wiesel, J P Bergerat, P Dufour, G Follea
• Journal: Biotherapy (Dordrecht, Netherlands) (Biotherapy) Vol. 2 Issue 1 Pg. 87-94 ( 1990) ISSN: 0921-299X [Print] Netherlands
• PMID: 2205259 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Staphylococcal Protein A
• Sepharose
• Fluorouracil

Topics

• Adult
• Aged
• Colorectal Neoplasms (pathology, surgery, therapy)
• Combined Modality Therapy
• Female
• Fluorouracil (administration & dosage)
• Humans
• Liver Neoplasms (secondary)
• Male
• Middle Aged
• Plasmapheresis
• Randomized Controlled Trials as Topic
• Sepharose
• Staphylococcal Protein A