UDP-glucuronosyltransferase (UGT) 1A1*28 polymorphism-directed phase II study of irinotecan with 5'-deoxy-5-fluorouridine (5'-DFUR) for metastatic colorectal cancer

Anticancer Res. 2013 Aug;33(8):3423-30.

Abstract

Aim: We performed a phase II study of irinotecan with 5'-deoxy-5-fluorouridine (5'-DFUR) for metastatic colorectal cancer based on UDP-glucuronosyltransferase (UGT) 1A1 polymorphism.

Patients and methods: A total of 28 patients were enrolled. The dose of irinotecan was 150 mg/m(2) for patients with the *1/*1 wild-type genotype, and 70 mg/m(2) for those with the *1/*28 mutated genotype. The primary end-point was the response rate (RR); secondary end-points were safety, time to treatment failure (TTF), and overall survival (OS).

Results: In 28 patients total, genotype was wild-type in 22 and mutated in six. The RR was *1/*1 (22.7%; wild-type) vs. *1/*28 (16.7%; mutated); the median TTF was 5 months vs. 4.5 months, and the median OS was 13 months vs. 17.5 months, respectively. None of these differences were significant. Toxicities of grade 3 or higher were neutropenia (9.0% vs. 0%, respectively) and diarrhea (13.6% vs. 0%, respectively).

Conclusion: This genotype-oriented therapy was effective and safe, and thus appears useful for patients who have complications or advanced age.

Keywords: 5’-deoxy-5-fluorouridine (5’-DFUR); Metastatic colorectal cancer; UDP-glucuronosyltransferase (UGT) 1A1*28 polymorphism; irinotecan.

Publication types

  • Clinical Trial, Phase II
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Antineoplastic Agents / therapeutic use
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Camptothecin / adverse effects
  • Camptothecin / analogs & derivatives*
  • Camptothecin / therapeutic use
  • Colorectal Neoplasms / drug therapy*
  • Colorectal Neoplasms / enzymology
  • Colorectal Neoplasms / genetics*
  • Colorectal Neoplasms / pathology
  • Female
  • Floxuridine / adverse effects
  • Floxuridine / analogs & derivatives*
  • Floxuridine / therapeutic use
  • Glucuronosyltransferase / genetics*
  • Humans
  • Irinotecan
  • Male
  • Middle Aged
  • Neoplasm Metastasis
  • Polymorphism, Genetic*
  • Survival Analysis
  • Time Factors
  • Treatment Outcome

Substances

  • Antineoplastic Agents
  • Floxuridine
  • Irinotecan
  • UGT1A1 enzyme
  • Glucuronosyltransferase
  • doxifluridine
  • Camptothecin