SAN FRANCISCO—Raltitrexed (Tomudex) in combination with oxaliplatin(Drug information on oxaliplatin) may be used as a replacement for the de Gramont regimen in advanced colorectal cancer, said Vincenzo Catalano, MD, Medical Oncology, Pesaro, Italy.
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(Drug information on 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 patients.
Treatment Regimen
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.
