Difference between revisions of "Colon cancer"
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(Created page with "==Adjuvant therapy== ===Capecitabine (Xeloda)=== *Capecitabine (Xeloda) 1250 mg/m2 PO BID days 1-14 '''Q21days x 8 cycles''' ====References==== # Twelves C, Wong A, Nowack...") |
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==Adjuvant therapy== | ==Adjuvant therapy== | ||
| + | |||
| + | ===5-FU & low-dose Leucovorin (Mayo Clinic regimen/LDLV)=== | ||
| + | ====Regimen==== | ||
| + | *[[Folinic acid (Leucovorin)]] 20 mg/m2 IV push before 5-FU days 1-5 | ||
| + | *[[Fluorouracil (5-FU)]] 425 mg/m2 IV push days 1-5 | ||
| + | |||
| + | Two different schedules have been used: | ||
| + | #'''Q4weeks x 3 cycles, then Q5weeks x 3 cycles''' | ||
| + | #'''Q4weeks x 6 cycles''' | ||
| + | |||
| + | ====References==== | ||
| + | # O'Connell MJ, Mailliard JA, Kahn MJ, Macdonald JS, Haller DG, Mayer RJ, Wieand HS. Controlled trial of fluorouracil and low-dose leucovorin given for 6 months as postoperative adjuvant therapy for colon cancer. J Clin Oncol. 1997 Jan;15(1):246-50. [http://jco.ascopubs.org/content/15/1/246.long link to original article] '''(contains protocol)''' [http://www.ncbi.nlm.nih.gov/pubmed/8996149 PubMed] | ||
| + | # Twelves C, Wong A, Nowacki MP, Abt M, Burris H 3rd, Carrato A, Cassidy J, Cervantes A, Fagerberg J, Georgoulias V, Husseini F, Jodrell D, Koralewski P, Kröning H, Maroun J, Marschner N, McKendrick J, Pawlicki M, Rosso R, Schüller J, Seitz JF, Stabuc B, Tujakowski J, Van Hazel G, Zaluski J, Scheithauer W. Capecitabine as adjuvant treatment for stage III colon cancer. N Engl J Med. 2005 Jun 30;352(26):2696-704. [http://www.nejm.org/doi/full/10.1056/NEJMoa043116 link to original article] '''(contains protocol)''' [http://www.ncbi.nlm.nih.gov/pubmed/15987918 PubMed] | ||
| + | # Haller DG, Catalano PJ, Macdonald JS, O'Rourke MA, Frontiera MS, Jackson DV, Mayer RJ. Phase III study of fluorouracil, leucovorin, and levamisole in high-risk stage II and III colon cancer: final report of Intergroup 0089. J Clin Oncol. 2005 Dec 1;23(34):8671-8. [http://jco.ascopubs.org/content/23/34/8671.long link to original article] '''(contains protocol)''' [http://www.ncbi.nlm.nih.gov/pubmed/16314627 PubMed] | ||
| + | # Schmoll HJ, Cartwright T, Tabernero J, Nowacki MP, Figer A, Maroun J, Price T, Lim R, Van Cutsem E, Park YS, McKendrick J, Topham C, Soler-Gonzalez G, de Braud F, Hill M, Sirzén F, Haller DG. Phase III trial of capecitabine plus oxaliplatin as adjuvant therapy for stage III colon cancer: a planned safety analysis in 1,864 patients. J Clin Oncol. 2007 Jan 1;25(1):102-9. [http://jco.ascopubs.org/content/25/1/102.long link to original article] '''(contains protocol)''' [http://www.ncbi.nlm.nih.gov/pubmed/17194911 PubMed] | ||
| + | |||
| + | ===5-FU & high-dose Leucovorin (Roswell Park regimen/HDLV)=== | ||
| + | ====Regimen==== | ||
| + | *[[Folinic acid (Leucovorin)]] 500 mg/m2 IV over 2 hours weekly x 6 weeks | ||
| + | *[[Fluorouracil (5-FU)]] 500 mg/m2 IV push 1 hour after start of leucovorin weekly x 6 weeks | ||
| + | |||
| + | '''Q8weeks x 4 cycles''' | ||
| + | |||
| + | ====References==== | ||
| + | # Haller DG, Catalano PJ, Macdonald JS, O'Rourke MA, Frontiera MS, Jackson DV, Mayer RJ. Phase III study of fluorouracil, leucovorin, and levamisole in high-risk stage II and III colon cancer: final report of Intergroup 0089. J Clin Oncol. 2005 Dec 1;23(34):8671-8. [http://jco.ascopubs.org/content/23/34/8671.long link to original article] '''(contains protocol)''' [http://www.ncbi.nlm.nih.gov/pubmed/16314627 PubMed] | ||
| + | # Lembersky BC, Wieand HS, Petrelli NJ, O'Connell MJ, Colangelo LH, Smith RE, Seay TE, Giguere JK, Marshall ME, Jacobs AD, Colman LK, Soran A, Yothers G, Wolmark N. Oral uracil and tegafur plus leucovorin compared with intravenous fluorouracil and leucovorin in stage II and III carcinoma of the colon: results from National Surgical Adjuvant Breast and Bowel Project Protocol C-06. J Clin Oncol. 2006 May 1;24(13):2059-64. [http://jco.ascopubs.org/content/24/13/2059.long link to original article] '''(contains protocol)''' [http://www.ncbi.nlm.nih.gov/pubmed/16648506 PubMed] | ||
| + | # Schmoll HJ, Cartwright T, Tabernero J, Nowacki MP, Figer A, Maroun J, Price T, Lim R, Van Cutsem E, Park YS, McKendrick J, Topham C, Soler-Gonzalez G, de Braud F, Hill M, Sirzén F, Haller DG. Phase III trial of capecitabine plus oxaliplatin as adjuvant therapy for stage III colon cancer: a planned safety analysis in 1,864 patients. J Clin Oncol. 2007 Jan 1;25(1):102-9. [http://jco.ascopubs.org/content/25/1/102.long link to original article] '''(contains protocol)''' [http://www.ncbi.nlm.nih.gov/pubmed/17194911 PubMed] | ||
===Capecitabine (Xeloda)=== | ===Capecitabine (Xeloda)=== | ||
| + | ====Regimen==== | ||
*[[Capecitabine (Xeloda)]] 1250 mg/m2 PO BID days 1-14 | *[[Capecitabine (Xeloda)]] 1250 mg/m2 PO BID days 1-14 | ||
| Line 8: | Line 36: | ||
====References==== | ====References==== | ||
# Twelves C, Wong A, Nowacki MP, Abt M, Burris H 3rd, Carrato A, Cassidy J, Cervantes A, Fagerberg J, Georgoulias V, Husseini F, Jodrell D, Koralewski P, Kröning H, Maroun J, Marschner N, McKendrick J, Pawlicki M, Rosso R, Schüller J, Seitz JF, Stabuc B, Tujakowski J, Van Hazel G, Zaluski J, Scheithauer W. Capecitabine as adjuvant treatment for stage III colon cancer. N Engl J Med. 2005 Jun 30;352(26):2696-704. [http://www.nejm.org/doi/full/10.1056/NEJMoa043116 link to original article] '''(contains protocol)''' [http://www.ncbi.nlm.nih.gov/pubmed/15987918 PubMed] | # Twelves C, Wong A, Nowacki MP, Abt M, Burris H 3rd, Carrato A, Cassidy J, Cervantes A, Fagerberg J, Georgoulias V, Husseini F, Jodrell D, Koralewski P, Kröning H, Maroun J, Marschner N, McKendrick J, Pawlicki M, Rosso R, Schüller J, Seitz JF, Stabuc B, Tujakowski J, Van Hazel G, Zaluski J, Scheithauer W. Capecitabine as adjuvant treatment for stage III colon cancer. N Engl J Med. 2005 Jun 30;352(26):2696-704. [http://www.nejm.org/doi/full/10.1056/NEJMoa043116 link to original article] '''(contains protocol)''' [http://www.ncbi.nlm.nih.gov/pubmed/15987918 PubMed] | ||
| + | |||
| + | ===FLOX=== | ||
| + | ====Regimen==== | ||
| + | *[[Fluorouracil (5-FU)]] 500 mg/m2 IV bolus 1 hour after start of leucovorin weekly x 6 weeks | ||
| + | *[[Folinic acid (Leucovorin)]] 500 mg/m2 IV over 2 hours weekly x 6 weeks | ||
| + | *[[Oxaliplatin (Eloxatin)]] 85 mg/m2 IV over 2 hours on weeks 1, 3, 5; given prior to 5-FU and leucovorin | ||
| + | |||
| + | '''Q8weeks x 3 cycles''' | ||
| + | |||
| + | ====References==== | ||
| + | # Kuebler JP, Wieand HS, O'Connell MJ, Smith RE, Colangelo LH, Yothers G, Petrelli NJ, Findlay MP, Seay TE, Atkins JN, Zapas JL, Goodwin JW, Fehrenbacher L, Ramanathan RK, Conley BA, Flynn PJ, Soori G, Colman LK, Levine EA, Lanier KS, Wolmark N. Oxaliplatin combined with weekly bolus fluorouracil and leucovorin as surgical adjuvant chemotherapy for stage II and III colon cancer: results from NSABP C-07. J Clin Oncol. 2007 Jun 1;25(16):2198-204. Epub 2007 Apr 30. [http://jco.ascopubs.org/content/25/16/2198.full link to original article] '''(contains protocol)''' [http://www.ncbi.nlm.nih.gov/pubmed/17470851 PubMed] | ||
===modified FOLFOX 6=== | ===modified FOLFOX 6=== | ||
| Line 21: | Line 60: | ||
[http://www.pieronline.jp/content/article/0385-0684/34020/203 link to original article (Japanese)] [http://www.ncbi.nlm.nih.gov/pubmed/17301527 PubMed] | [http://www.pieronline.jp/content/article/0385-0684/34020/203 link to original article (Japanese)] [http://www.ncbi.nlm.nih.gov/pubmed/17301527 PubMed] | ||
| − | === | + | ===FULV=== |
====Regimen==== | ====Regimen==== | ||
*[[Fluorouracil (5-FU)]] 500 mg/m2 IV bolus 1 hour after start of leucovorin weekly x 6 | *[[Fluorouracil (5-FU)]] 500 mg/m2 IV bolus 1 hour after start of leucovorin weekly x 6 | ||
*[[Folinic acid (Leucovorin)]] 500 mg/m2 IV over 2 hours weekly x 6 | *[[Folinic acid (Leucovorin)]] 500 mg/m2 IV over 2 hours weekly x 6 | ||
| − | |||
'''Q8weeks x 3 cycles''' | '''Q8weeks x 3 cycles''' | ||
| Line 32: | Line 70: | ||
# Kuebler JP, Wieand HS, O'Connell MJ, Smith RE, Colangelo LH, Yothers G, Petrelli NJ, Findlay MP, Seay TE, Atkins JN, Zapas JL, Goodwin JW, Fehrenbacher L, Ramanathan RK, Conley BA, Flynn PJ, Soori G, Colman LK, Levine EA, Lanier KS, Wolmark N. Oxaliplatin combined with weekly bolus fluorouracil and leucovorin as surgical adjuvant chemotherapy for stage II and III colon cancer: results from NSABP C-07. J Clin Oncol. 2007 Jun 1;25(16):2198-204. Epub 2007 Apr 30. [http://jco.ascopubs.org/content/25/16/2198.full link to original article] '''(contains protocol)''' [http://www.ncbi.nlm.nih.gov/pubmed/17470851 PubMed] | # Kuebler JP, Wieand HS, O'Connell MJ, Smith RE, Colangelo LH, Yothers G, Petrelli NJ, Findlay MP, Seay TE, Atkins JN, Zapas JL, Goodwin JW, Fehrenbacher L, Ramanathan RK, Conley BA, Flynn PJ, Soori G, Colman LK, Levine EA, Lanier KS, Wolmark N. Oxaliplatin combined with weekly bolus fluorouracil and leucovorin as surgical adjuvant chemotherapy for stage II and III colon cancer: results from NSABP C-07. J Clin Oncol. 2007 Jun 1;25(16):2198-204. Epub 2007 Apr 30. [http://jco.ascopubs.org/content/25/16/2198.full link to original article] '''(contains protocol)''' [http://www.ncbi.nlm.nih.gov/pubmed/17470851 PubMed] | ||
| − | === | + | ===UFT & leucovorin=== |
====Regimen==== | ====Regimen==== | ||
| − | *[[ | + | *[[Uracil-tegafur (UFT)]] 100 mg/m2 PO Q8H (total dose of 300 mg/m2/day) x 4 weeks |
| − | *[[Folinic acid (Leucovorin)]] | + | *[[Folinic acid (Leucovorin)]] 30 mg PO Q8H (total dose of 90 mg/day) x 4 weeks |
| + | *No food for 1 hour before and after each dose of medication. | ||
| − | ''' | + | '''Q5weeks x 5 cycles''' |
====References==== | ====References==== | ||
| − | # | + | # Lembersky BC, Wieand HS, Petrelli NJ, O'Connell MJ, Colangelo LH, Smith RE, Seay TE, Giguere JK, Marshall ME, Jacobs AD, Colman LK, Soran A, Yothers G, Wolmark N. Oral uracil and tegafur plus leucovorin compared with intravenous fluorouracil and leucovorin in stage II and III carcinoma of the colon: results from National Surgical Adjuvant Breast and Bowel Project Protocol C-06. J Clin Oncol. 2006 May 1;24(13):2059-64. [http://jco.ascopubs.org/content/24/13/2059.long link to original article] '''(contains protocol)''' [http://www.ncbi.nlm.nih.gov/pubmed/16648506 PubMed] |
===XELOX (CapeOx)=== | ===XELOX (CapeOx)=== | ||
Revision as of 07:41, 11 December 2011
Adjuvant therapy
5-FU & low-dose Leucovorin (Mayo Clinic regimen/LDLV)
Regimen
- Folinic acid (Leucovorin) 20 mg/m2 IV push before 5-FU days 1-5
- Fluorouracil (5-FU) 425 mg/m2 IV push days 1-5
Two different schedules have been used:
- Q4weeks x 3 cycles, then Q5weeks x 3 cycles
- Q4weeks x 6 cycles
References
- O'Connell MJ, Mailliard JA, Kahn MJ, Macdonald JS, Haller DG, Mayer RJ, Wieand HS. Controlled trial of fluorouracil and low-dose leucovorin given for 6 months as postoperative adjuvant therapy for colon cancer. J Clin Oncol. 1997 Jan;15(1):246-50. link to original article (contains protocol) PubMed
- Twelves C, Wong A, Nowacki MP, Abt M, Burris H 3rd, Carrato A, Cassidy J, Cervantes A, Fagerberg J, Georgoulias V, Husseini F, Jodrell D, Koralewski P, Kröning H, Maroun J, Marschner N, McKendrick J, Pawlicki M, Rosso R, Schüller J, Seitz JF, Stabuc B, Tujakowski J, Van Hazel G, Zaluski J, Scheithauer W. Capecitabine as adjuvant treatment for stage III colon cancer. N Engl J Med. 2005 Jun 30;352(26):2696-704. link to original article (contains protocol) PubMed
- Haller DG, Catalano PJ, Macdonald JS, O'Rourke MA, Frontiera MS, Jackson DV, Mayer RJ. Phase III study of fluorouracil, leucovorin, and levamisole in high-risk stage II and III colon cancer: final report of Intergroup 0089. J Clin Oncol. 2005 Dec 1;23(34):8671-8. link to original article (contains protocol) PubMed
- Schmoll HJ, Cartwright T, Tabernero J, Nowacki MP, Figer A, Maroun J, Price T, Lim R, Van Cutsem E, Park YS, McKendrick J, Topham C, Soler-Gonzalez G, de Braud F, Hill M, Sirzén F, Haller DG. Phase III trial of capecitabine plus oxaliplatin as adjuvant therapy for stage III colon cancer: a planned safety analysis in 1,864 patients. J Clin Oncol. 2007 Jan 1;25(1):102-9. link to original article (contains protocol) PubMed
5-FU & high-dose Leucovorin (Roswell Park regimen/HDLV)
Regimen
- Folinic acid (Leucovorin) 500 mg/m2 IV over 2 hours weekly x 6 weeks
- Fluorouracil (5-FU) 500 mg/m2 IV push 1 hour after start of leucovorin weekly x 6 weeks
Q8weeks x 4 cycles
References
- Haller DG, Catalano PJ, Macdonald JS, O'Rourke MA, Frontiera MS, Jackson DV, Mayer RJ. Phase III study of fluorouracil, leucovorin, and levamisole in high-risk stage II and III colon cancer: final report of Intergroup 0089. J Clin Oncol. 2005 Dec 1;23(34):8671-8. link to original article (contains protocol) PubMed
- Lembersky BC, Wieand HS, Petrelli NJ, O'Connell MJ, Colangelo LH, Smith RE, Seay TE, Giguere JK, Marshall ME, Jacobs AD, Colman LK, Soran A, Yothers G, Wolmark N. Oral uracil and tegafur plus leucovorin compared with intravenous fluorouracil and leucovorin in stage II and III carcinoma of the colon: results from National Surgical Adjuvant Breast and Bowel Project Protocol C-06. J Clin Oncol. 2006 May 1;24(13):2059-64. link to original article (contains protocol) PubMed
- Schmoll HJ, Cartwright T, Tabernero J, Nowacki MP, Figer A, Maroun J, Price T, Lim R, Van Cutsem E, Park YS, McKendrick J, Topham C, Soler-Gonzalez G, de Braud F, Hill M, Sirzén F, Haller DG. Phase III trial of capecitabine plus oxaliplatin as adjuvant therapy for stage III colon cancer: a planned safety analysis in 1,864 patients. J Clin Oncol. 2007 Jan 1;25(1):102-9. link to original article (contains protocol) PubMed
Capecitabine (Xeloda)
Regimen
- Capecitabine (Xeloda) 1250 mg/m2 PO BID days 1-14
Q21days x 8 cycles
References
- Twelves C, Wong A, Nowacki MP, Abt M, Burris H 3rd, Carrato A, Cassidy J, Cervantes A, Fagerberg J, Georgoulias V, Husseini F, Jodrell D, Koralewski P, Kröning H, Maroun J, Marschner N, McKendrick J, Pawlicki M, Rosso R, Schüller J, Seitz JF, Stabuc B, Tujakowski J, Van Hazel G, Zaluski J, Scheithauer W. Capecitabine as adjuvant treatment for stage III colon cancer. N Engl J Med. 2005 Jun 30;352(26):2696-704. link to original article (contains protocol) PubMed
FLOX
Regimen
- Fluorouracil (5-FU) 500 mg/m2 IV bolus 1 hour after start of leucovorin weekly x 6 weeks
- Folinic acid (Leucovorin) 500 mg/m2 IV over 2 hours weekly x 6 weeks
- Oxaliplatin (Eloxatin) 85 mg/m2 IV over 2 hours on weeks 1, 3, 5; given prior to 5-FU and leucovorin
Q8weeks x 3 cycles
References
- Kuebler JP, Wieand HS, O'Connell MJ, Smith RE, Colangelo LH, Yothers G, Petrelli NJ, Findlay MP, Seay TE, Atkins JN, Zapas JL, Goodwin JW, Fehrenbacher L, Ramanathan RK, Conley BA, Flynn PJ, Soori G, Colman LK, Levine EA, Lanier KS, Wolmark N. Oxaliplatin combined with weekly bolus fluorouracil and leucovorin as surgical adjuvant chemotherapy for stage II and III colon cancer: results from NSABP C-07. J Clin Oncol. 2007 Jun 1;25(16):2198-204. Epub 2007 Apr 30. link to original article (contains protocol) PubMed
modified FOLFOX 6
Regimen
- Fluorouracil (5-FU) 400 mg/m2 IV bolus on day 1, then 1200 mg/m2/day IV continuous infusion over 46-48 hours
- Folinic acid (Leucovorin) 400 mg/m2 IV over 2 hours day 1
- Oxaliplatin (Eloxatin) 85 mg/m2 IV over 2 hours day 1
Q14days x 12 cycles
References
- Kojima S, Ina K, Futamura Y, Ito Y, Hibi S, Nagaoka M, Yuasa S, Kawai M, Nagao S, Kataoka T. A phase I study of modified FOLFOX 6 therapy for advanced colorectal cancer. Gan To Kagaku Ryoho. 2007 Feb;34(2):203-6.
link to original article (Japanese) PubMed
FULV
Regimen
- Fluorouracil (5-FU) 500 mg/m2 IV bolus 1 hour after start of leucovorin weekly x 6
- Folinic acid (Leucovorin) 500 mg/m2 IV over 2 hours weekly x 6
Q8weeks x 3 cycles
References
- Kuebler JP, Wieand HS, O'Connell MJ, Smith RE, Colangelo LH, Yothers G, Petrelli NJ, Findlay MP, Seay TE, Atkins JN, Zapas JL, Goodwin JW, Fehrenbacher L, Ramanathan RK, Conley BA, Flynn PJ, Soori G, Colman LK, Levine EA, Lanier KS, Wolmark N. Oxaliplatin combined with weekly bolus fluorouracil and leucovorin as surgical adjuvant chemotherapy for stage II and III colon cancer: results from NSABP C-07. J Clin Oncol. 2007 Jun 1;25(16):2198-204. Epub 2007 Apr 30. link to original article (contains protocol) PubMed
UFT & leucovorin
Regimen
- Uracil-tegafur (UFT) 100 mg/m2 PO Q8H (total dose of 300 mg/m2/day) x 4 weeks
- Folinic acid (Leucovorin) 30 mg PO Q8H (total dose of 90 mg/day) x 4 weeks
- No food for 1 hour before and after each dose of medication.
Q5weeks x 5 cycles
References
- Lembersky BC, Wieand HS, Petrelli NJ, O'Connell MJ, Colangelo LH, Smith RE, Seay TE, Giguere JK, Marshall ME, Jacobs AD, Colman LK, Soran A, Yothers G, Wolmark N. Oral uracil and tegafur plus leucovorin compared with intravenous fluorouracil and leucovorin in stage II and III carcinoma of the colon: results from National Surgical Adjuvant Breast and Bowel Project Protocol C-06. J Clin Oncol. 2006 May 1;24(13):2059-64. link to original article (contains protocol) PubMed
XELOX (CapeOx)
Regimen
- Capecitabine (Xeloda) 1000 mg/m2 PO BID days 1-14
- Oxaliplatin (Eloxatin) 130 mg/m2 IV over 2 hours day 1
Q21days x 8 cycles
References
- Schmoll HJ, Cartwright T, Tabernero J, Nowacki MP, Figer A, Maroun J, Price T, Lim R, Van Cutsem E, Park YS, McKendrick J, Topham C, Soler-Gonzalez G, de Braud F, Hill M, Sirzén F, Haller DG. Phase III trial of capecitabine plus oxaliplatin as adjuvant therapy for stage III colon cancer: a planned safety analysis in 1,864 patients. J Clin Oncol. 2007 Jan 1;25(1):102-9. link to original article (contains protocol) PubMed
- Cassidy J, Clarke S, Díaz-Rubio E, Scheithauer W, Figer A, Wong R, Koski S, Lichinitser M, Yang TS, Rivera F, Couture F, Sirzén F, Saltz L. Randomized phase III study of capecitabine plus oxaliplatin compared with fluorouracil/folinic acid plus oxaliplatin as first-line therapy for metastatic colorectal cancer. J Clin Oncol. 2008 Apr 20;26(12):2006-12. link to original article (contains protocol) PubMed