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Among the oral fluoropirimidine formulations, capecitabine mimicks protracted infusion of 5-FU.
A prior phase I study combined oxaliplatin, protracted infusion 5FU and radiation in a preoperative setting (Khushalani et al, 2002).
Administration of the combined chemotherapeutic agents involved protracted infusion of 5-FU in 14 patients (47%) and oral S-1 in 16 patients (53%).
Another phase I trial was conducted, using the combination of oxaliplatin, cisplatin and protracted infusion 5FU associated with a standard radiotherapy dose of 50.4 Gy (Maurel et al, 2005).
A recent phase III trial in advanced colorectal cancer comparing protracted infusion of 5-FU with or without the addition of MMC demonstrated an overall response rate of 45% for the combination and 38% for 5-FU alone.
Fluorouracil is known to be most effective when administered as a protracted infusion but such schedules require indwelling catheters and in pancreatic cancer these cause particular problems with venous thromboembolism.
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Repeated intravenous administrations or protracted infusions are heavy for patients.
In the specific setting of cardiopathic patients with aggressive NHL, value of liposomal doxorubicin deserves comparison with the less cardiotoxic protracted infusions of doxorubicin or newer anthracycline congeners.
Plantar-palmar erythrodysesthesia, an epithelial toxicity observed in patients receiving protracted infusions or repeated dose-intensive administration of doxorubicin (Samuels et al, 1987; Bronchud et al, 1989), and the dose-limiting side-effect of caelyxs™ (Ranson et al, 1997), was not observed with DaunoXome in this study.
A randomised study of 320 patients with untreated advanced CRC compared protracted venous infusion of 5FU (PVI 5FU) plus MMC and circadian-timed infusion of 5FU plus MMC (Price et al, 2004).
When taken orally these drugs are much more convenient to administer than 5-FU, which usually requires protracted venous infusion.
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