Phase I study of 5-day continuous infusion fluorodeoxyuridine and high-dose folinic acid with oral hydroxyurea

James W. Raschko, Steven A. Akman, Lucille A. Leong, Kim A. Margolin, Robert J. Morgan, Edward Newman, George Somlo, Chul Ahn, James H. Doroshow

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Fluorodeoxyuridine (FUdR), the deoxynucleoside metabolite of 5-fluorouracil (5-FU), can be converted in a single step to fluorodeoxyuridine monophosphate (FdUMP), which binds covalently to thymidylate synthase (TS). Ribonucleotide reductase, an obligatory enzyme in the synthesis of deoxynucleotides, can be inhibited by hydroxyurea. Recognizing the well-established synergism between 5-FU and folinic acid (leucovorin), we hypothesized that the simultaneous administration of FUdR, leucovorin, and hydroxyurea might afford more effective inhibition of TS. Thirty-six patients with neoplastic disease considered refractory to standard therapy were entered into this phase I protocol. Treatment was administered on days 1 through 5 of a 28-day cycle and consisted of folinic acid (500 mg m-2 day-1) and FUdR at escalating doses of 0.1, 0.15, or 0.2 mg kg-1 day-1 both administered by continuous i.v. infusion, and hydroxyurea given p.o. once per day at doses ranging from 0 to 2500 mg in 500-mg increments. The hydroxyurea and FUdR levels were escalated in a sequential fashion. The majority of patients had refractory breast or lung cancer. Dose-limiting toxicities were mucositis and diarrhea at the maximally tolerated dose of 0.15 mg/kg FUdR and 2000 mg hydroxyurea per day in conjunction with high-dose folinic acid. Hematological toxicity was minor. Of the 18 patients in whom response could be evaluated, none had evidence of objective disease regression. Mucositis and diarrhea are the dose-limiting toxicities when continuous infusions of FUdR and high-dose folinic acid are combined with oral hydroxyurea, effects that are consistent with the observed toxicities for FUdR when administered alone or in combination with leucovorin.

Original languageEnglish (US)
Pages (from-to)161-164
Number of pages4
JournalCancer Chemotherapy and Pharmacology
Volume35
Issue number2
DOIs
StatePublished - Mar 1994

Fingerprint

Floxuridine
Hydroxyurea
Leucovorin
Toxicity
Thymidylate Synthase
Mucositis
Fluorouracil
Refractory materials
Diarrhea
Ribonucleotide Reductases
Maximum Tolerated Dose
Metabolites
Lung Neoplasms
Breast Neoplasms

Keywords

  • Fluorodeoxyuridine
  • Folinic acid
  • Hydroxyurea

ASJC Scopus subject areas

  • Pharmacology
  • Oncology
  • Cancer Research

Cite this

Raschko, J. W., Akman, S. A., Leong, L. A., Margolin, K. A., Morgan, R. J., Newman, E., ... Doroshow, J. H. (1994). Phase I study of 5-day continuous infusion fluorodeoxyuridine and high-dose folinic acid with oral hydroxyurea. Cancer Chemotherapy and Pharmacology, 35(2), 161-164. https://doi.org/10.1007/BF00686640

Phase I study of 5-day continuous infusion fluorodeoxyuridine and high-dose folinic acid with oral hydroxyurea. / Raschko, James W.; Akman, Steven A.; Leong, Lucille A.; Margolin, Kim A.; Morgan, Robert J.; Newman, Edward; Somlo, George; Ahn, Chul; Doroshow, James H.

In: Cancer Chemotherapy and Pharmacology, Vol. 35, No. 2, 03.1994, p. 161-164.

Research output: Contribution to journalArticle

Raschko, JW, Akman, SA, Leong, LA, Margolin, KA, Morgan, RJ, Newman, E, Somlo, G, Ahn, C & Doroshow, JH 1994, 'Phase I study of 5-day continuous infusion fluorodeoxyuridine and high-dose folinic acid with oral hydroxyurea', Cancer Chemotherapy and Pharmacology, vol. 35, no. 2, pp. 161-164. https://doi.org/10.1007/BF00686640
Raschko, James W. ; Akman, Steven A. ; Leong, Lucille A. ; Margolin, Kim A. ; Morgan, Robert J. ; Newman, Edward ; Somlo, George ; Ahn, Chul ; Doroshow, James H. / Phase I study of 5-day continuous infusion fluorodeoxyuridine and high-dose folinic acid with oral hydroxyurea. In: Cancer Chemotherapy and Pharmacology. 1994 ; Vol. 35, No. 2. pp. 161-164.
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