SAN FRANCISCORaltitrexed (Tomudex) in combination with oxaliplatin may be used as a replacement for the de Gramont regimen in
advanced colorectal cancer, said Vincenzo Catalano, MD, Medical Oncology,
The combination offers equivalent efficacy with more convenient dosing, he
said. (Both agents are investigational in the United States.)
Oxaliplatin, Dr. Catalano noted, has shown activity in the treatment of
advanced colorectal cancer, mainly in combination with fluorouracil (5-FU) and
folinic acid administered in the de Gramont schedule (5-FU bolus plus 22-hr
infusion) repeated every 2 weeks.
Raltitrexed, a potent, specific thymidylate synthase inhibitor, has the
advantage of allowing every-3-week administration of a 15-minute infusion, Dr.
Catalano said in an interview at the 37th Annual Meeting of the American
Society of Clinical Oncology (ASCO abstract 576).
Dr. Catalano’s phase II multicenter trial enrolled 60 patients (median
age, 61 years) who were chemonaïve or who had completed prior adjuvant
chemotherapy at least 6 months before the current study. All patients had
confirmed, relapsed, or metastatic colorectal cancer. Prevalent metastatic
sites were the liver in 45 patients, lungs in 16 patients, and lymph nodes in 6
Treatment consisted of raltitrexed 3 mg/m² (15-minute intravenous infusion)
followed by oxaliplatin 100 mg/m² (2-hour intravenous infusion), repeated every
3 weeks. At the time of the presentation, 41 patients had received three or
more cycles of chemotherapy and 19 were ongoing.