Korean J Intern Med.  2005 Sep;20(3):205-209. 10.3904/kjim.2005.20.3.205.

Irinotecan, Continuous 5-Fluorouracil, and Low dose of Leucovorin (modified FOLFIRI) as First Line of Therapy in Recurrent or Metastatic Colorectal Cancer

• Lee MA
• Byun JH
• Shim BY
• Woo IS
• Kang JH
• Hong YS
• Lee KS
• Choi MG
• Chang SK
• Oh ST
• Choi SI
• Lee DS

• KMID: 1782231
• DOI: http://doi.org/10.3904/kjim.2005.20.3.205

Abstract

BACKGROUND
Irinotecan, in combination with 5-fluorouracil (5-FU) and a high dose of leucovorin (LV), known as FOLFIRI regimen, has shown activity in recurrent or metastatic colorectal cancer. Therefore, we evaluated the efficacy and safety of irinotecan, 5-FU and a low dose of LV (modified FOLFIRI) as a first line of therapy for patients with relapsed or metastatic colorectal cancer. METHODS: Between January 2002 and October 2004, 44 patients with histologically confirmed recurrent or metastatic colorectal cancer were enrolled. The chemotherapy regimen schedule consisted of 180 mg/m2 of irinotecan being administered intravenously (i.v) on Day 1, 400 mg/m2 of 5-FU via i.v bolus with 600 mg/m2 of continuous infusion for 22 hrs on both Day 1 and 2, and 20 mg/m2 of leucovorin on both Day 1 and 2, repeated every two weeks. RESULTS: The overall response rate was 47.8%. Of the 40 evaluated patients, one had CR (2.3%) and 20 had PR (46.5%). Toxicities were mild and easily manageable. Three patients experienced 23 episodes of Grade 3/4 leukopenia., Only one patient developed Grade 3/4 diarrhea. None experienced Grade 3/4 thrombocytopenia. CONCLUSION: Modified FOLFIRI with a low dose of LV is an effective and tolerable regimen for patients with recurrent or metastatic colorectal cancer.

Keyword

Irinotecan; 5-FU; Leucovorin; Colorectal cancer

MeSH Terms

Neoplasm Recurrence, Local/*drug therapy
Neoplasm Metastasis/*drug therapy
Middle Aged
Male
Leucovorin/administration & dosage
Humans
Fluorouracil/administration & dosage
Female
Disease Progression
Colorectal Neoplasms/*drug therapy/pathology
Camptothecin/administration & dosage/analogs & derivatives
Antineoplastic Combined Chemotherapy Protocols/*administration & dosage
Aged
Adult