Modulation of 5-Fluorouracil with High-Dose Leucovorin Calcium

Activity in Ovarian Cancer and Correlation with CA-125 Levels

Robert J. Morgan, James Speyer, James H. Doroshow, Kim Margolin, James Raschko, J. Sorich, Steven Akman, Lucille Leong, George Somlo, Steven Vasilev, Chul Ahn, Dina Johnson, U. Beller

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Abstract

The purpose of this study was to estimate the response rate, response duration, and survival of patients with advanced ovarian cancer treated with a 132-hr continuous infusion of high-dose calcium leucovorin in combination with five consecutive daily bolus doses of 5-fluorouracil (5-FU) and to correlate changes in CA-125 levels with clinical and radiologic assessment of disease progression. Forty-six heavily pretreated patients [median number of previous chemotherapy regimens, 2.5 (range 1-7)] with advanced ovarian cancer received 132-hr continuous infusions of calcium leucovorin (500 mg/m2/day) for 5 1 2 days, with daily bolus doses of 5-FU (370 mg/m2/day) for 5 days beginning 24 hr after initiation of the calcium leucovorin. Twenty-three patients had clinically measurable disease and 23 had evaluable disease; CA-125 levels were performed prior to each treatment course and after the final course of therapy. One of 42 patients had a partial response to combination chemotherapy (duration, 8.9 months); 16/42 had stable disease [median duration, 4.9 months (range, 2.4-9.0 months)]. Toxicity of combination therapy included mild myelosuppression and stomatitis, similar to previously reported toxicity profiles for the 5-FU and calcium leucovorin combinations. Sensitivity of CA-125 levels as a single indicator of disease progression was 55%. The combination of infusional high-dose calcium leucovorin and 5-FU has little activity in refractory ovarian cancer. CA-125 levels incorrectly predict clinical disease activity in about one-third of cases and should not be the sole criterion for determination of clinical response when evaluating chemotherapeutic efficacy in heavily pretreated patients.

Original languageEnglish (US)
Pages (from-to)79-85
Number of pages7
JournalGynecologic Oncology
Volume58
Issue number1
DOIs
StatePublished - Jul 1995

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Leucovorin
Fluorouracil
Ovarian Neoplasms
Disease Progression
Stomatitis
Combination Drug Therapy
Therapeutics
Drug Therapy
Survival

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynecology

Cite this

Morgan, R. J., Speyer, J., Doroshow, J. H., Margolin, K., Raschko, J., Sorich, J., ... Beller, U. (1995). Modulation of 5-Fluorouracil with High-Dose Leucovorin Calcium: Activity in Ovarian Cancer and Correlation with CA-125 Levels. Gynecologic Oncology, 58(1), 79-85. https://doi.org/10.1006/gyno.1995.1187

Modulation of 5-Fluorouracil with High-Dose Leucovorin Calcium : Activity in Ovarian Cancer and Correlation with CA-125 Levels. / Morgan, Robert J.; Speyer, James; Doroshow, James H.; Margolin, Kim; Raschko, James; Sorich, J.; Akman, Steven; Leong, Lucille; Somlo, George; Vasilev, Steven; Ahn, Chul; Johnson, Dina; Beller, U.

In: Gynecologic Oncology, Vol. 58, No. 1, 07.1995, p. 79-85.

Research output: Contribution to journalArticle

Morgan, RJ, Speyer, J, Doroshow, JH, Margolin, K, Raschko, J, Sorich, J, Akman, S, Leong, L, Somlo, G, Vasilev, S, Ahn, C, Johnson, D & Beller, U 1995, 'Modulation of 5-Fluorouracil with High-Dose Leucovorin Calcium: Activity in Ovarian Cancer and Correlation with CA-125 Levels', Gynecologic Oncology, vol. 58, no. 1, pp. 79-85. https://doi.org/10.1006/gyno.1995.1187
Morgan, Robert J. ; Speyer, James ; Doroshow, James H. ; Margolin, Kim ; Raschko, James ; Sorich, J. ; Akman, Steven ; Leong, Lucille ; Somlo, George ; Vasilev, Steven ; Ahn, Chul ; Johnson, Dina ; Beller, U. / Modulation of 5-Fluorouracil with High-Dose Leucovorin Calcium : Activity in Ovarian Cancer and Correlation with CA-125 Levels. In: Gynecologic Oncology. 1995 ; Vol. 58, No. 1. pp. 79-85.
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