A fixed-ratio combination of uracil and ftorafur (UFT) with low dose leucovorin. An active oral regimen for advanced colorectal cancer

Leonard B. Saltz(American Cancer Society), Cynthia G. Leichman(University of Southern California), Charles W. Young(Memorial Sloan Kettering Cancer Center), Franco M. Muggia(USC Norris Comprehensive Cancer Center), John A. Conti(Memorial Sloan Kettering Cancer Center), Tara Spiess(Memorial Sloan Kettering Cancer Center), Susan Jeffers(USC Norris Comprehensive Cancer Center), Lawrence P. Leichman(University of Southern California)
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Abstract

BACKGROUND: UFT is a fixed-ratio combination of uracil and Ftorafur, a prodrug that is absorbed orally and metabolized in vivo to 5-fluorouracil (5-FU). Uracil potentiates 5-FU through interference with its catabolism. The combination of UFT and leucovorin in patients with advanced incurable colorectal cancer, to evaluate preliminary activity and toxicity in this patient population. METHODS: Twenty-one patients were treated. Twenty patients were evaluable for toxicity and response. Patients received UFT 350 mg/m2/day divided every 8 hours. Patients took a 5 mg tablet of leucovorin every 8 hours, concurrent with each UFT dose. Treatment was continued for 28 consecutive days, followed by a 7-day rest. RESULTS: Five major objective responses (one complete and four partial) were observed. Toxicity was mild, with no dose-limiting myelosuppression. Four patients experienced grade 3 diarrhea or higher, and two patients experienced dose-limiting mucositis. CONCLUSION: UFT and low dose leucovorin is a well tolerated, orally administered regimen with activity in colorectal cancer. A randomized comparison of this regimen with conventional parenteral regimens is warranted.


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