A phase II trial of irinotecan, 5-fluorouracil and leucovorin combined with celecoxib and glutamine as first-line therapy for advanced colorectal cancer

Chong Xian Pan, Patrick Loehrer, David Seitz, Paul Helft, Beth Juliar, Rafat Ansari, William Pletcher, Jake Vinson, Liang Cheng, Christopher Sweeney

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Objectives: Preclinical and clinical data indicate that cyclooxygenase-2 (COX-2) is a bona fide molecular target for colorectal cancer (CRC). Glutamine may decrease chemotherapy-associated diarrhea. This study was designed to address whether the addition of celecoxib, a COX-2 inhibitor, and glutamine would improve the efficacy and decrease the toxicities of the irinotecan, fluorouracil and leucovorin (IFL) regimen. Methods: All patients received the original IFL regimen plus celecoxib (400 mg, po, every 12 h continuously while on trial) and glutamine (10 g, po, every 8 h continuously while on chemotherapy). Results: Of the 41 patients enrolled, 40 patients received between 1 and 6 cycles of treatment. This regimen was associated with significant toxicities: 45.0% had grade 3 diarrhea, 35.0% grade 3/4 neutropenia, 22.5% hospitalization, 10.0% deep vein thrombosis and 2 treatment-related deaths. The overall response rate was 47.2%. The median progression-free survival was 6.7 months. The median overall survival was 16.3 months. The 12-month overall survival rate was 54.8%. COX-2 expression was present in 63.2% of the specimens evaluated. There was no significant correlation between COX-2 expression and response to chemotherapy (p = 0.739). Conclusion: The addition of celecoxib and glutamine appears not to improve the efficacy or decrease the toxicities of IFL for the treatment of metastatic CRC.

Original languageEnglish (US)
Pages (from-to)63-70
Number of pages8
JournalONCOLOGY
Volume69
Issue number1
DOIs
StatePublished - Aug 1 2005

Fingerprint

irinotecan
Celecoxib
Leucovorin
Glutamine
Fluorouracil
Colorectal Neoplasms
Cyclooxygenase 2
Drug Therapy
Diarrhea
Glycyrrhetinic Acid
Cyclooxygenase 2 Inhibitors
Therapeutics
Neutropenia
Venous Thrombosis
Disease-Free Survival
Hospitalization
Survival Rate
Survival

Keywords

  • 5-Fluorouracil
  • Celecoxib
  • Colorectal cancer
  • Glutamine
  • Irinotecan

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

A phase II trial of irinotecan, 5-fluorouracil and leucovorin combined with celecoxib and glutamine as first-line therapy for advanced colorectal cancer. / Pan, Chong Xian; Loehrer, Patrick; Seitz, David; Helft, Paul; Juliar, Beth; Ansari, Rafat; Pletcher, William; Vinson, Jake; Cheng, Liang; Sweeney, Christopher.

In: ONCOLOGY, Vol. 69, No. 1, 01.08.2005, p. 63-70.

Research output: Contribution to journalArticle

Pan, Chong Xian ; Loehrer, Patrick ; Seitz, David ; Helft, Paul ; Juliar, Beth ; Ansari, Rafat ; Pletcher, William ; Vinson, Jake ; Cheng, Liang ; Sweeney, Christopher. / A phase II trial of irinotecan, 5-fluorouracil and leucovorin combined with celecoxib and glutamine as first-line therapy for advanced colorectal cancer. In: ONCOLOGY. 2005 ; Vol. 69, No. 1. pp. 63-70.
@article{293636b0dad942109923a465253c5890,
title = "A phase II trial of irinotecan, 5-fluorouracil and leucovorin combined with celecoxib and glutamine as first-line therapy for advanced colorectal cancer",
abstract = "Objectives: Preclinical and clinical data indicate that cyclooxygenase-2 (COX-2) is a bona fide molecular target for colorectal cancer (CRC). Glutamine may decrease chemotherapy-associated diarrhea. This study was designed to address whether the addition of celecoxib, a COX-2 inhibitor, and glutamine would improve the efficacy and decrease the toxicities of the irinotecan, fluorouracil and leucovorin (IFL) regimen. Methods: All patients received the original IFL regimen plus celecoxib (400 mg, po, every 12 h continuously while on trial) and glutamine (10 g, po, every 8 h continuously while on chemotherapy). Results: Of the 41 patients enrolled, 40 patients received between 1 and 6 cycles of treatment. This regimen was associated with significant toxicities: 45.0{\%} had grade 3 diarrhea, 35.0{\%} grade 3/4 neutropenia, 22.5{\%} hospitalization, 10.0{\%} deep vein thrombosis and 2 treatment-related deaths. The overall response rate was 47.2{\%}. The median progression-free survival was 6.7 months. The median overall survival was 16.3 months. The 12-month overall survival rate was 54.8{\%}. COX-2 expression was present in 63.2{\%} of the specimens evaluated. There was no significant correlation between COX-2 expression and response to chemotherapy (p = 0.739). Conclusion: The addition of celecoxib and glutamine appears not to improve the efficacy or decrease the toxicities of IFL for the treatment of metastatic CRC.",
keywords = "5-Fluorouracil, Celecoxib, Colorectal cancer, Glutamine, Irinotecan",
author = "Pan, {Chong Xian} and Patrick Loehrer and David Seitz and Paul Helft and Beth Juliar and Rafat Ansari and William Pletcher and Jake Vinson and Liang Cheng and Christopher Sweeney",
year = "2005",
month = "8",
day = "1",
doi = "10.1159/000087302",
language = "English (US)",
volume = "69",
pages = "63--70",
journal = "Oncology",
issn = "0890-9091",
publisher = "UBM Medica Healthcare Publications",
number = "1",

}

TY - JOUR

T1 - A phase II trial of irinotecan, 5-fluorouracil and leucovorin combined with celecoxib and glutamine as first-line therapy for advanced colorectal cancer

AU - Pan, Chong Xian

AU - Loehrer, Patrick

AU - Seitz, David

AU - Helft, Paul

AU - Juliar, Beth

AU - Ansari, Rafat

AU - Pletcher, William

AU - Vinson, Jake

AU - Cheng, Liang

AU - Sweeney, Christopher

PY - 2005/8/1

Y1 - 2005/8/1

N2 - Objectives: Preclinical and clinical data indicate that cyclooxygenase-2 (COX-2) is a bona fide molecular target for colorectal cancer (CRC). Glutamine may decrease chemotherapy-associated diarrhea. This study was designed to address whether the addition of celecoxib, a COX-2 inhibitor, and glutamine would improve the efficacy and decrease the toxicities of the irinotecan, fluorouracil and leucovorin (IFL) regimen. Methods: All patients received the original IFL regimen plus celecoxib (400 mg, po, every 12 h continuously while on trial) and glutamine (10 g, po, every 8 h continuously while on chemotherapy). Results: Of the 41 patients enrolled, 40 patients received between 1 and 6 cycles of treatment. This regimen was associated with significant toxicities: 45.0% had grade 3 diarrhea, 35.0% grade 3/4 neutropenia, 22.5% hospitalization, 10.0% deep vein thrombosis and 2 treatment-related deaths. The overall response rate was 47.2%. The median progression-free survival was 6.7 months. The median overall survival was 16.3 months. The 12-month overall survival rate was 54.8%. COX-2 expression was present in 63.2% of the specimens evaluated. There was no significant correlation between COX-2 expression and response to chemotherapy (p = 0.739). Conclusion: The addition of celecoxib and glutamine appears not to improve the efficacy or decrease the toxicities of IFL for the treatment of metastatic CRC.

AB - Objectives: Preclinical and clinical data indicate that cyclooxygenase-2 (COX-2) is a bona fide molecular target for colorectal cancer (CRC). Glutamine may decrease chemotherapy-associated diarrhea. This study was designed to address whether the addition of celecoxib, a COX-2 inhibitor, and glutamine would improve the efficacy and decrease the toxicities of the irinotecan, fluorouracil and leucovorin (IFL) regimen. Methods: All patients received the original IFL regimen plus celecoxib (400 mg, po, every 12 h continuously while on trial) and glutamine (10 g, po, every 8 h continuously while on chemotherapy). Results: Of the 41 patients enrolled, 40 patients received between 1 and 6 cycles of treatment. This regimen was associated with significant toxicities: 45.0% had grade 3 diarrhea, 35.0% grade 3/4 neutropenia, 22.5% hospitalization, 10.0% deep vein thrombosis and 2 treatment-related deaths. The overall response rate was 47.2%. The median progression-free survival was 6.7 months. The median overall survival was 16.3 months. The 12-month overall survival rate was 54.8%. COX-2 expression was present in 63.2% of the specimens evaluated. There was no significant correlation between COX-2 expression and response to chemotherapy (p = 0.739). Conclusion: The addition of celecoxib and glutamine appears not to improve the efficacy or decrease the toxicities of IFL for the treatment of metastatic CRC.

KW - 5-Fluorouracil

KW - Celecoxib

KW - Colorectal cancer

KW - Glutamine

KW - Irinotecan

UR - http://www.scopus.com/inward/record.url?scp=23944460013&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=23944460013&partnerID=8YFLogxK

U2 - 10.1159/000087302

DO - 10.1159/000087302

M3 - Article

C2 - 16088234

AN - SCOPUS:23944460013

VL - 69

SP - 63

EP - 70

JO - Oncology

JF - Oncology

SN - 0890-9091

IS - 1

ER -