National Cancer Institute - NCI Division of Cancer Treatment and ...

Delaunoit T, Goldberg RM, Sargent DJ, Morton
RF, Fuchs CS, Findlay BP, Thomas SP, Salim M,
Schaefer PL, Stella PJ, Green E, Mailliard JA.
Mortality associated with daily bolus 5-fluorouracil/leucovorin
administered in combination
with either irinotecan or oxaliplatin: results from
Intergroup Trial N9741. Cancer 2004:101;2170–6.
Rothenberg ML, Meropol NJ, Poplin EA, Van
Cutsem E, Wadler S. Mortality associated with
irinotecan plus bolus fluorouracil/leucovorin:
summary findings of an independent panel.
J Clin Oncol 2001:19;3801–7.
Continuous-Infusion Fluorouracil
Diminishes Severe Toxicity but Does
Not Improve DFS or OS in Adjuvant
Treatment of Stage III and High-Risk
Stage II Colon Cancer
Modest toxicity and possibly enhanced
activity make continuous-infusion fluorouracil
(CIFU) an attractive alternative to
fluorouracil plus leucovorin (FU/LV) for the
adjuvant treatment of colorectal cancer.
CTEP sponsored SWOG to perform SWOG-
9415 to compare the efficacy of CIFU plus
levamisole to FU/LV plus levamisole in the
adjuvant treatment of high-risk Dukes’ B2
and C1 or C2 colon cancer. At least one
grade 4 toxicity occurred in 39 percent of
patients receiving FU/LV and 5 percent of
patients receiving CIFU. However, almost
twice as many patients receiving CIFU
discontinued therapy early compared
with those receiving FU/LV.
The five-year OS was 70 percent for FU/LV
and 69 percent for CIFU. The corresponding
five-year DFS was 61 percent and 63
percent, respectively. CIFU had less severe
toxicity but did not improve DFS or OS in
comparison with bolus FU/LV.
Poplin EA, Benedetti JK, Estes NC, Haller DG,
Mayer RJ, Goldberg RM, Weiss GR, Rivkin SE,
Macdonald JS. Phase III Southwest Oncology
Group 9415/Intergroup 0153 randomized trial
of fluorouracil, leucovorin, and levamisole
versus fluorouracil continuous infusion and
levamisole for adjuvant treatment of stage III
and high-risk stage II colon cancer. J Clin Oncol
2005:23;1819–25.
Meta-analysis Group in Cancer. Efficacy of
intravenous continuous infusion of fluorouracil
compared with bolus administration
in advanced colorectal cancer. J Clin Oncol
1998:16;301–8.
Sentinel Nodes Predict Survival
for Melanoma Patients
Treatment of patients with primary
cutaneous melanoma and clinically
normal regional lymph nodes has been
controversial. Melanoma is more likely
to be fatal if it has spread to the nearby
lymph nodes. Nevertheless, only 20 percent
of melanoma patients turn out to
have cancerous lymph nodes; removing
all of them as a matter of course can cause
significant complications. In this study, a
minimally invasive technique called lymphatic
mapping and sentinel-node biopsy
(LM/SNB)—which looks for cancer in a
few nodes first—was better than a watchand-wait
approach in helping melanoma
patients whose cancer had spread to the
lymph nodes to live longer.
Between 1994 and 2002, the research
team enrolled 2001 patients with stage I
melanoma in the United States, Europe,
and Australia. The patients were randomly
assigned to one of two groups. One group
(the watch-and-wait group) had surgery to
remove the melanoma followed by
C A N C E R T H E R A P Y E V A L U A T I O N P R O G R A M ■ 87