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

Research output: Contribution to journalArticle

29 Scopus citations

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

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynecology

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    Morgan, R. J., Speyer, J., Doroshow, J. H., 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, 58(1), 79-85. https://doi.org/10.1006/gyno.1995.1187