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Oxaliplatin/Fluorouracil/Leucovorin in Advanced Colorectal Carcinoma: an Asian Experience

Oncology Registrar, Department of Haematology/Oncology, National University Hospital, Singapore

Robert Seng Cheong Lim, MD

Oncology Consultant, Department of Haematology/Oncology, National University Hospital

Tuck Seng Wu, BPharm (Hons)

Head Pharmacist, Department of Pharmacy, National University Hospital

Hwai Loong Kong, MB BS

Oncology Consultant, Department of Haematology/Oncology, National University Hospital

Reprints: Elaine Hsuen Lim MB BCh, Department of Haematology/Oncology, National University Hospital, 5 Lower Kent Ridge Rd., Singapore 119074, FAX 65 6777 5545, mdclime{at}nus.edu.sg

BACKGROUND: Oxaliplatin/fluorouracil/leucovorin (FOLFOX4) is an effective and generally well-tolerated regimen in Western studies of metastatic colorectal carcinoma.

OBJECTIVE: To evaluate the objective tumor responses and toxicities of the FOLFOX4 regimen in a predominantly Chinese population with advanced colorectal carcinoma in Singapore.

METHODS: Forty-seven consecutive patients were enrolled in a retrospective study between March 1998 and December 2001. FOLFOX4 was first-line treatment in 36% of these patients, second-line in 36%, third-line in 17%, and fourth-line in 11%. Tumor responses were assessed radiologically, and toxicities were graded by the National Cancer Institute common toxicity system.

RESULTS: The objective response rate (all partial responses) was 45%, and stable disease was achieved in 35% of the patients. There were no deaths due to toxicity. Mild to moderate peripheral sensory neuropathy affected half of the patients, with 1 report of cold exacerbation in this tropical series. The rate of hypersensitivity reactions to oxaliplatin was 11%, and they usually occurred late in the treatment course.

CONCLUSIONS: FOLFOX4 has good efficacy in metastatic colorectal carcinoma in our local population, but the rate of hypersensitivity reactions to oxaliplatin was high.

Key Words: Asian, colorectal carcinoma, hypersensitivity, oxaliplatin

Published Online, October 15, 2003. www.theannals.com, DOI 10.1345/aph.1D153

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