Annals of Oncology 13:755-759, 2002
© 2002 European Society for Medical Oncology
Original Paper |
A phase I study of oral uracil–ftorafur plus folinic acid in combination with weekly paclitaxel in patients with solid tumors
1Abteilung für Onkologie, Hämatologie, Immunologie und Rheumatologie, Universitätsklinikum Tübingen, Tübingen; 2Asklepios Fachkliniken München-Gauting, Gauting; 3Johannes Gutenberg Universität Mainz, Mainz; 4St Johannes Hospital, Duisburg, Germany
Received 6 August 2001; revised 13 November 2001; accepted 5 December 2001.
Introduction
Ftorafur is an orally available prodrug of 5-fluorouracil (5-FU). Its combination with uracil in a molar ratio of 1:4 (UFT) increases the 5-FU concentration in tumor cells compared with ftorafur alone. Paclitaxel has a broad spectrum of activity against solid tumors and synergic effects with UFT have been demonstrated in vitro. A phase I study was performed to determine the maximum tolerated dose of the combination of UFT and paclitaxel in patients with advanced solid tumors.
Study design
UFT and folinic acid were applied at 300 mg/m2/day and 90 mg/day, respectively, on days 1–28, repeated on day 36. Paclitaxel was applied on days 1, 8, 15 and 22 of each cycle. The starting dose of paclitaxel was 50 mg/m2 and escalation in 10 mg/m2 steps was performed up to 100 mg/m2 weekly.
Results
Forty-seven consecutive patients with various solid tumors have been included in six different dose levels. One hundred and thirty cycles have been applied. The treatment was well tolerated overall. Most frequently encountered adverse effects were gastrointestinal and hematological toxicity (diarrhea CTC 3/4 in 6% of patients, anemia in 11%, leukocytopenia in 9%, polyneuropathy in 9%, fatigue in 11%, other in 6%). Partial remissions were observed in 28% of patients.
Conclusion
Owing to the lack of overlapping toxicities, UFT/folinic acid plus paclitaxel can be combined at doses of proven single agent activity. Side effects are mainly attributable to the gastrointestinal toxicity of UFT and to the neuro- and hematotoxicity of paclitaxel. The recommended doses for phase II studies are 300 mg/m2 of UFT plus 90 mg of folinic acid on days 1–28, and 90 mg/m2 of paclitaxel weekly.
Key words: dose escalation, paclitaxel, phase I/II, phase I study, solid tumors, UFT
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