Phase I/II trial of 5-fluorouracil, leucovorin, zidovudine and dipyridamole for patients with metastatic colorectal cancer, renal cell carcinoma and malignant melanoma

William Sharfman, W. J. Urba, J. W. Smith, J. E. Janik, B. D. Curti, B. L. Gause, J. T. Holmlund, R. G. Steis, A. E. Beauchamp, D. L. Longo

Research output: Contribution to journalArticle

Abstract

We conducted a phase I/II trial of 5-fluorouracil (5-FU), calcium leucovorin (LV), zidovudine (AZT) and dipyridamole (DP), (FLAP) in patients with metastatic colorectal cancer, renal cell carcinoma and malignant melanoma. AZT and DP were given to enhance the biochemical modulation and antitumor activity of 5-FU and LV. All patients received 5-FU (370 mg/m2 i.v. bolus day 0-4), LV (50 mg/m2 p.o. every 4 h day 0-4) and DP (50 mg/m2 p.o. every 6 h days 0-27). In the phase I portion of the study, AZT was dose escalated in cohorts of 5 patients each, from 50 mg p.o. everty 6 h days 0-27 to the MTD of 200 mg p.o. every 6 h days 0-27. Thirty-three patients received 200 mg of AZT in the phase II portion of the trial. Eleven patients developed grade III and 5 patients developed grade IV leukopenia. Four patients developed grade III and 21 patients developed grade IV neutropenia, with six febrile neutropenic episodes. Six patients experienced grade III anemia and four grade III thrombocytopenia. Diarrhea or stomatitis of ≥ grade III occurred in six and four patients, respectively. Fifty-eight percent (19 of 33) of patients required dose reductions of AZT for hematologic toxicity (13 of 19 in the first treatment cycle). At the 200 mg AZT dose level, there were two partial responses in nine colorectal cancer patients (22%), no objective responses in 14 patients with renal cell carcinoma or in 14 patients with melanoma. FLAP does not have significant activity in melanoma, renal cell carcinoma or 5-FU-treated colorectal cancer patients, although it may have activity in untreated colon cancer.

Original languageEnglish (US)
Pages (from-to)579-583
Number of pages5
JournalInternational Journal of Oncology
Volume6
Issue number3
StatePublished - 1995
Externally publishedYes

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Dipyridamole
Leucovorin
Zidovudine
Renal Cell Carcinoma
Fluorouracil
Colorectal Neoplasms
Melanoma
Stomatitis
Leukopenia
Neutropenia
Thrombocytopenia
Colonic Neoplasms

Keywords

  • biochemical modulation
  • thymidylate synthase

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Phase I/II trial of 5-fluorouracil, leucovorin, zidovudine and dipyridamole for patients with metastatic colorectal cancer, renal cell carcinoma and malignant melanoma. / Sharfman, William; Urba, W. J.; Smith, J. W.; Janik, J. E.; Curti, B. D.; Gause, B. L.; Holmlund, J. T.; Steis, R. G.; Beauchamp, A. E.; Longo, D. L.

In: International Journal of Oncology, Vol. 6, No. 3, 1995, p. 579-583.

Research output: Contribution to journalArticle

Sharfman, W, Urba, WJ, Smith, JW, Janik, JE, Curti, BD, Gause, BL, Holmlund, JT, Steis, RG, Beauchamp, AE & Longo, DL 1995, 'Phase I/II trial of 5-fluorouracil, leucovorin, zidovudine and dipyridamole for patients with metastatic colorectal cancer, renal cell carcinoma and malignant melanoma', International Journal of Oncology, vol. 6, no. 3, pp. 579-583.
Sharfman, William ; Urba, W. J. ; Smith, J. W. ; Janik, J. E. ; Curti, B. D. ; Gause, B. L. ; Holmlund, J. T. ; Steis, R. G. ; Beauchamp, A. E. ; Longo, D. L. / Phase I/II trial of 5-fluorouracil, leucovorin, zidovudine and dipyridamole for patients with metastatic colorectal cancer, renal cell carcinoma and malignant melanoma. In: International Journal of Oncology. 1995 ; Vol. 6, No. 3. pp. 579-583.
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abstract = "We conducted a phase I/II trial of 5-fluorouracil (5-FU), calcium leucovorin (LV), zidovudine (AZT) and dipyridamole (DP), (FLAP) in patients with metastatic colorectal cancer, renal cell carcinoma and malignant melanoma. AZT and DP were given to enhance the biochemical modulation and antitumor activity of 5-FU and LV. All patients received 5-FU (370 mg/m2 i.v. bolus day 0-4), LV (50 mg/m2 p.o. every 4 h day 0-4) and DP (50 mg/m2 p.o. every 6 h days 0-27). In the phase I portion of the study, AZT was dose escalated in cohorts of 5 patients each, from 50 mg p.o. everty 6 h days 0-27 to the MTD of 200 mg p.o. every 6 h days 0-27. Thirty-three patients received 200 mg of AZT in the phase II portion of the trial. Eleven patients developed grade III and 5 patients developed grade IV leukopenia. Four patients developed grade III and 21 patients developed grade IV neutropenia, with six febrile neutropenic episodes. Six patients experienced grade III anemia and four grade III thrombocytopenia. Diarrhea or stomatitis of ≥ grade III occurred in six and four patients, respectively. Fifty-eight percent (19 of 33) of patients required dose reductions of AZT for hematologic toxicity (13 of 19 in the first treatment cycle). At the 200 mg AZT dose level, there were two partial responses in nine colorectal cancer patients (22{\%}), no objective responses in 14 patients with renal cell carcinoma or in 14 patients with melanoma. FLAP does not have significant activity in melanoma, renal cell carcinoma or 5-FU-treated colorectal cancer patients, although it may have activity in untreated colon cancer.",
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AU - Smith, J. W.

AU - Janik, J. E.

AU - Curti, B. D.

AU - Gause, B. L.

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AU - Steis, R. G.

AU - Beauchamp, A. E.

AU - Longo, D. L.

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