Sequential Methotrexate and 5-Fluorouracil as Second-Line Chemotherapy for Advanced Colorectal Cancer Patients Pretreated with 5-Fluorouracil and Leucovorin: a GISCAD Study

摘要: Abstract The biochemical modulation of 5-fluorouracil (5-FU) by means methotrexate (MTX) and 6-S leucovorin (LV) seems mainly directed at two different intracellular targets, supporting the hypothesis possible non-cross resistance between these methods 5-FU potentia-tion. Thirty-one patients, all previously treated with LV for advanced colorectal cancer (ACC), were MTX=200 mg/m2 iv day 1 600 2 10 po q 6 h X starting 24 after MTX, repeated every weeks. Of 30 eva-luable Partial Remissions (PR) achieved (Response Rate=6.6%; 95% Confidence Interval 0%-14%). Eight patients had disease stabilization (SD). overall median survival was 5 months (range 1-11). No WHO grade III-IV toxicities reported. Despite good tolerability, this combination rescue has minimal activity in ACC failure 5FU+LV-based chemotherapy.