Symptomatic effects of methotrexate, 5fluorouracil and leucovorin in advanced colorectal cancer after failure of 5FU continuous infusion

Twenty-two advanced colorectal cancer patients, refractory to 5FU CI, were given methotrexate 200 mg/m(2) as a 30 minutes i.v. infusion, followed 24 hours later by 5FU at the dose of 600 mg/m(2) as a 15 minutes i.v. infusion, and leucovorin 10 mg/m(2) orally every 6 hours for 6 times. The cycle was repeated every 2 weeks. There were two partial responses (9%; 95% CI 6%-12%), while eleven patients achieved a stabilization of disease. Toxicity was extremely mild. Symptoms relief occurred in 26/41 cases (63%), Median duration of palliation was 11 weeks (range 4-18), Our results confirm that biochemical modulation with MTX is not a satisfactory mean of increasing 5FU activity in patients previously exposed to 5FU CI, However, the significant symptom palliation appears highly worthwhile, and it could be considered in the decision to treat symptomatic colorectal cancer patients refractory to 5FU CI.