Spanish researchers have found that patients treated every week with Camptosar® (irinotecan, CPT-11) plus a high dose of continuous infusion 5-FU (fluorouracil) without leucovorin had similar outcomes to those treated with the more common biweekly FOLFIRI treatment that includes leucovorin. FOLFIRI is Camptosar, 5-FU, and leucovorin. The new treatment is called FUIRI.
In a randomized trial, patients received either FOLFIRI every two weeks or FUIRI weekly. None had been treated for advanced (metastatic) colorectal cancer before.
In the study of 346 patients a comparison of FOLFIRI versus FUIRI found
- Tumor shrinkage (response rates) were 57 percent for FOLFIRI and 51 percent for FUIRI.
- Time until cancer worsened (progression-free survival) was 8.3 months for FOLFIRI and 8.4 months for FUIRI.
- Median overall survival also wasn’t significantly different: 21.6 months versus 19.2 months.
Serious side effects differed between the two regimens with
- Patients having low white cell counts (neutropenia) more often with FOLFIRI: 27 percent vs. 9 percent.
- More diarrhea in the weekly FUIRI treatment: 21 percent for FOLFIRI vs 42 percent for FUIRI.
Members of the Spanish Cooperative Group for the Study of Digestive Tumors concluded,
FUIRI represents a valid alternative without leucovorin to the FOLFIRI regimen as metastatic colorectal cancer first-line treatment.
SOURCE: Aranda et. al, Annals of Oncology, Advance Access published online August 20, 2008.