Background: The combination of 5-fluorouracil (5-FU) and folinic acid (FA) has demonstrated activity in most gastrointestinal tumors. The addition of epirubicin (Epi) could increase the efficacy of the combination. This was examined in patients with advanced gastric cancer who had previously received chemotherapy with FAM (5-FU + adriamycin + mitomycin) and relapsed. Patients and Method: The schedule was conducted in 30 patients who had previously received FAM. It consisted of FA 200 mg/m2/day intravenous push administration prior to 5-FU infusion 600 mg/m2/day in 500 ml 5 % normal saline over 1 h for 5 days; Epi 35 mg/m2/day intravenous bolus before FA + 5-FU administration on days 1 and 2. Additionally, allopurinol (AL) 300 mg, 1 tablet × 3/day, started 2 days before treatment for 17 days. The cycle was repeated every 28 days. Results: The sites of the largest measurable lesion included local relapse in 19 patients, liver metastases in 17, and lymph node metastases in 16 patients. Pretreatment characteristics included: age 33-72 (median 63) years, and Karnofsky Performance Status of 80-90%. All patients were evaluable for response and toxicity. Objective tumor responses (partial responses) were seen in 8 of 30 patients (26%) (5 had previously stable diseases and 3 partial responses to FAM). The estimated median survival was 21.8 weeks measured from the onset of therapy, duration of response was 13.6 weeks and time to progression, 19 weeks. Toxocity resulted primarily in nausea and vomiting, diarrhea, alopecia, myelosuppression, and mucositis. Conclusion: We conclude that this second-line combination of Epi + FA + 5-FU with AL protection has moderate activity and increased toxicity in the treatment of advanced gastric cancer.

Keywords:
Gastric cancer, Chemotherapy, Folinic acid, 5-Fluorouracil, Epirubicin, Allopurinol
This content is only available via PDF.
© 1995 S. Karger AG, Basel
1995
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.