Phase I Trial of Hepatic Artery Infusion of 5-Iodo-2″-deoxyuridine and 5-Fluorouracil in Patients with Advanced Hepatic Malignancy: Biochemically Based Combination Chemotherapy

Scot C. Remick, Al B Benson III, James L. Weese, James K.V. Willson, Guillermo Ramirez, George W. Wirtanen, Dona B. Alberti, Lavonne M. Nieting, Kendra D. Tutsch, Paul H. Fischer, Donald L. Trump

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16 Scopus citations

Abstract

Eighteen patients with hepatic metastases primarily from colorectal carcinoma were treated on a phase I protocol employing hepatic artery infusion (HAI) of 5-fluorouracil (FUra) and 5-iodo-2'-deoxyuridine (IdUrd) via an implantable infusion pump. Patients received a 14-day continuous HAI of 300 mg/day FUra. During days 8–14 of therapy, patients received IdUrd as a separate 3-h HAI daily × 7. Treatment cycles were repeated every 28 days. IdUrd was escalated from 0.1 to 2.86 mg/kg/day × 7. Myelosuppression and stomatitis were mild and not dose limiting. Hepatotoxicity was dose limiting and similar to that reported for 5-fluoro-2″-deoxyuridine alone administered as a 14-day infusion every month. One patient developed a clinical picture consistent with sclerosing cholangitis and another had biopsy-proven cholestasis and triaditis. Catheter complications occurred in 7 of 18 patients. Plasma concentrations of FUra during the 7-day continuous HAI of FUra alone were consistently either undetectable or very low (≤0.1 μm). At level 3 (1.0 mg/kg/day IdUrd) and beyond, measurable plasma concentrations of FUra, iodouracil, and IdUrd were found at the end of the daily 3-h infusion of IdUrd. The maximum tolerated dose of IdUrd as administered in this trial is 2.2 mg/kg/day × 7 and the recommended starting dose for further clinical investigation is 1.7 mg/kg/day × 7.

Original languageEnglish (US)
Pages (from-to)6437-6442
Number of pages6
JournalCancer Research
Volume49
Issue number22
StatePublished - Nov 15 1989

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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