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Published in: Journal of Cancer Research and Clinical Oncology 6/2004

01-06-2004 | Original Paper

Epirubicin, cisplatin, and protracted infusion of 5-FU (ECF) in advanced intrahepatic cholangiocarcinoma

Authors: Myung Ah Lee, In Sook Woo, Jin-Hyoung Kang, Young Seon Hong, Kyung Shik Lee

Published in: Journal of Cancer Research and Clinical Oncology | Issue 6/2004

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Abstract

Purpose

Intrahepatic cholangiocarcinoma usually presents late in the clinical course and has a poor prognosis. No effective systemic therapy is currently available. This study aimed to determine the efficacy and toxicity of the ECF regimen (epirubicin, cisplatin. and 24-h continuous infusion of 5-FU) in advanced intrahepatic cholangiocarcinoma.

Patients and method

On day 1, epirubicin 50 mg/m2 and cisplatin 60 mg/m2 were administered i.v., repeated every 21 days. 5-FU (200 mg/m2/day was given continuous i.v. via an ambulatory infusion pump throughout the treatment course. A total of 24 patients (15 men and nine women) with advanced intrahepatic cholangiocarcinoma between August 1996 and April 2002 were enrolled in this study.

Results

Of the 20 evaluable patients, two had partial response (10%) and nine had stable disease (45%), including two minor response. Grade 3/4 neutropenia was observed in six patients, while grade 3/4 thrombocytopenia was seen in five patients. There was no neutropenic infection or thrombocytopenic bleeding during any of the cycles of chemotherapy.

Conclusion

ECF regimen is well-tolerated but is not an effective treatment for advanced intrahepatic cholangiocarcinoma. Newer clinical trials with combination drugs should be developed.
Literature
go back to reference Adjei AA, Klein CE, Kastrissios H, Goldberg RM, Alberts SR, Pitot HC, Sloan JA, Reid JM, Hanson LJ, Atherton P, Rubin J, Erlichman C (2000) Phase I and pharmacokinetic study of irinotecan and docetaxel in patients with advanced solid tumors: preliminary evidence of clinical activity. J Clin Oncol 18:1116–1123PubMed Adjei AA, Klein CE, Kastrissios H, Goldberg RM, Alberts SR, Pitot HC, Sloan JA, Reid JM, Hanson LJ, Atherton P, Rubin J, Erlichman C (2000) Phase I and pharmacokinetic study of irinotecan and docetaxel in patients with advanced solid tumors: preliminary evidence of clinical activity. J Clin Oncol 18:1116–1123PubMed
go back to reference Ahn SY, Cha TJ, Seo SH, Lee SW, Han BW, Goo JY, Park BC (1990) Clinical aspects of Phase I trial of 5-day continuous venous infusion of oxaliplatin at circadian rhythm-modulated rate compared with constant rate. J Natl Cancer Inst 82:1046–1050PubMed Ahn SY, Cha TJ, Seo SH, Lee SW, Han BW, Goo JY, Park BC (1990) Clinical aspects of Phase I trial of 5-day continuous venous infusion of oxaliplatin at circadian rhythm-modulated rate compared with constant rate. J Natl Cancer Inst 82:1046–1050PubMed
go back to reference Arai Y, Inaba Y, Takeuchi Y (1997) Interventional techniques for hepatic arterial infusion chemotherapy. In: Castaneda-Zuniga WR (ed) Interventional radiology, 3rd edn. Williams & Wilkins, Maryland, pp 192–205 Arai Y, Inaba Y, Takeuchi Y (1997) Interventional techniques for hepatic arterial infusion chemotherapy. In: Castaneda-Zuniga WR (ed) Interventional radiology, 3rd edn. Williams & Wilkins, Maryland, pp 192–205
go back to reference Chen JS, Jan YY, Lin YC, Wang HM, Chang WC, Liau CT (1998) Weekly 24 h infusion of high-dose 5-fluorouracil and leucovorin in patients with biliary tract carcinomas. Anticancer Drugs 9:393–397PubMed Chen JS, Jan YY, Lin YC, Wang HM, Chang WC, Liau CT (1998) Weekly 24 h infusion of high-dose 5-fluorouracil and leucovorin in patients with biliary tract carcinomas. Anticancer Drugs 9:393–397PubMed
go back to reference Davis HL Jr, Ramirez G, Ansfield FJ (1974) Adenocarcinomas of stomach, pancreas, liver and biliary tracts. Survival of 328 patients treated with fluoropyrimidine therapy. Cancer 33:193–197PubMed Davis HL Jr, Ramirez G, Ansfield FJ (1974) Adenocarcinomas of stomach, pancreas, liver and biliary tracts. Survival of 328 patients treated with fluoropyrimidine therapy. Cancer 33:193–197PubMed
go back to reference Ducreux M, Rougier P, Fandi A, Clavero-Fabri MC, Villing AL, Fassone F, Fandi L, Zarba J, Armand JP (1998) Effective treatment of advanced biliary tract carcinoma using 5-fluorouracil continuous infusion with cisplatin. Ann Oncol 9:653–656CrossRefPubMed Ducreux M, Rougier P, Fandi A, Clavero-Fabri MC, Villing AL, Fassone F, Fandi L, Zarba J, Armand JP (1998) Effective treatment of advanced biliary tract carcinoma using 5-fluorouracil continuous infusion with cisplatin. Ann Oncol 9:653–656CrossRefPubMed
go back to reference Ellis PA, Norman A, Hill A, O’Brien ME, Nicolson M, Hickish T, Cunningham D (1995) Epirubicin, cisplatin and infusional 5-fluorouracil (5-FU) (ECF) in hepatobiliary tumors. Eur J Cancer 31A:1594–1598 Ellis PA, Norman A, Hill A, O’Brien ME, Nicolson M, Hickish T, Cunningham D (1995) Epirubicin, cisplatin and infusional 5-fluorouracil (5-FU) (ECF) in hepatobiliary tumors. Eur J Cancer 31A:1594–1598
go back to reference Falkson G, MacIntyre JM, Moertel CG (1984) Eastern cooperative oncology group experience with chemotherapy for inoperable gallbladder and bile duct cancer. Cancer 54:965–969PubMed Falkson G, MacIntyre JM, Moertel CG (1984) Eastern cooperative oncology group experience with chemotherapy for inoperable gallbladder and bile duct cancer. Cancer 54:965–969PubMed
go back to reference Findlay M, Cunningham D, Norman A, Mansi J, Nicolson M, Hickish T, Nicolson V, Nash A, Sacks N, Ford H (1994) A phase II study in advanced gastro-esophageal cancer using epirubicin and cisplatin in combination with continuous infusion 5-fluorouracil (ECF). Ann Oncol 5:609–616PubMed Findlay M, Cunningham D, Norman A, Mansi J, Nicolson M, Hickish T, Nicolson V, Nash A, Sacks N, Ford H (1994) A phase II study in advanced gastro-esophageal cancer using epirubicin and cisplatin in combination with continuous infusion 5-fluorouracil (ECF). Ann Oncol 5:609–616PubMed
go back to reference Fong Y, Kemeny N, Lawrence TS (2001) Cancer of the liver and biliary trees. In: DeVita VT, Helman S, Rosenberg SA (eds) Cancer: principles & practice of oncology, 6th edn. Lippincott Williams & Wilkins, Philadelphia, p 1178 Fong Y, Kemeny N, Lawrence TS (2001) Cancer of the liver and biliary trees. In: DeVita VT, Helman S, Rosenberg SA (eds) Cancer: principles & practice of oncology, 6th edn. Lippincott Williams & Wilkins, Philadelphia, p 1178
go back to reference Harvey JH, Smith FP, Schein PS (1984) 5-fluorouracil, mitomycin, and doxorubicin (FAM) in carcinoma of the biliary tract. J Clin Oncol 2:1245–1248PubMed Harvey JH, Smith FP, Schein PS (1984) 5-fluorouracil, mitomycin, and doxorubicin (FAM) in carcinoma of the biliary tract. J Clin Oncol 2:1245–1248PubMed
go back to reference Ikeguchi M, Hirooka Y, Makino M, Kaibara N (2001) Dihydropyrimidine dehydrogenase activity of cancerous and non-cancerous tissues in liver and large intestine. Oncol Rep 8:621–625PubMed Ikeguchi M, Hirooka Y, Makino M, Kaibara N (2001) Dihydropyrimidine dehydrogenase activity of cancerous and non-cancerous tissues in liver and large intestine. Oncol Rep 8:621–625PubMed
go back to reference Ito Y, Takeda T, Sasaki Y, Sakon M, Monden M, Yamada T, Ishiguro S, Imaoka S, Tsujimoto M, Matsuura N (2000) Bcl-2 expression in cholangiocellular carcinoma is inversely correlated with biologically aggressive phenotypes. Oncology 59:63–67CrossRefPubMed Ito Y, Takeda T, Sasaki Y, Sakon M, Monden M, Yamada T, Ishiguro S, Imaoka S, Tsujimoto M, Matsuura N (2000) Bcl-2 expression in cholangiocellular carcinoma is inversely correlated with biologically aggressive phenotypes. Oncology 59:63–67CrossRefPubMed
go back to reference Kubicka S, Rudolph KL, Tietze MK, Lorenz M, Manns M (2001) Phase II study of systemic gemcitabine chemotherapy for advanced unresectable hepatobiliary carcinomas. Hepatogastroenterology 48:783–789PubMed Kubicka S, Rudolph KL, Tietze MK, Lorenz M, Manns M (2001) Phase II study of systemic gemcitabine chemotherapy for advanced unresectable hepatobiliary carcinomas. Hepatogastroenterology 48:783–789PubMed
go back to reference Liver cancer study group of Japan (1987) Primary liver cancer in Japan: sixth report. Cancer 60:1400–1411PubMed Liver cancer study group of Japan (1987) Primary liver cancer in Japan: sixth report. Cancer 60:1400–1411PubMed
go back to reference Nakajima T, Kondo Y, Miyazaki M, Okui K (1998) A histopathologic study of 102 cases of intrahepatic cholangiocarcinoma. Hum Pathol 19:112–134 Nakajima T, Kondo Y, Miyazaki M, Okui K (1998) A histopathologic study of 102 cases of intrahepatic cholangiocarcinoma. Hum Pathol 19:112–134
go back to reference Okuda K, Kubo Y, Okazaki N, Arishima T, Hashimoto M (1977) Clinical aspects of intrahepatic bile duct carcinoma including hilar carcinoma: a study of 57 autopsy-proven cases. Cancer 39:232–246PubMed Okuda K, Kubo Y, Okazaki N, Arishima T, Hashimoto M (1977) Clinical aspects of intrahepatic bile duct carcinoma including hilar carcinoma: a study of 57 autopsy-proven cases. Cancer 39:232–246PubMed
go back to reference Patt YZ, Jones DV Jr, Hoque A, Lozano R, Markowitz A, Raijman I, Lynch P, Charnsangavej C (1996) Phase II trial of intravenous fluorouracil and subcutaneous interferon alfa-2b for biliary tract cancer. J Clin Oncol 14:2311–2315PubMed Patt YZ, Jones DV Jr, Hoque A, Lozano R, Markowitz A, Raijman I, Lynch P, Charnsangavej C (1996) Phase II trial of intravenous fluorouracil and subcutaneous interferon alfa-2b for biliary tract cancer. J Clin Oncol 14:2311–2315PubMed
go back to reference Patt YZ, Hassan MM, Lozano RD, Waugh KA, Hoque AM, Frome AI, Lahoti S, Ellis L, Vauthey JN, Curley SA, Schnirer II, Raijman I (2001) Phase II trial of cisplatin, interferon alpha-2b, doxorubicin, and 5-fluorouracil for biliary tract cancer. Clin Cancer Res 7:3375–3380PubMed Patt YZ, Hassan MM, Lozano RD, Waugh KA, Hoque AM, Frome AI, Lahoti S, Ellis L, Vauthey JN, Curley SA, Schnirer II, Raijman I (2001) Phase II trial of cisplatin, interferon alpha-2b, doxorubicin, and 5-fluorouracil for biliary tract cancer. Clin Cancer Res 7:3375–3380PubMed
go back to reference Raderer M, Hejna MH, Valencak JB, Kornek GV, Weinlander GS, Bareck E, Lenauer J, Brodowicz T, Lang F, Scheithauer W (1999) Two consecutive phase II studies of 5-fluorouracil/leucovorin/mitomycin C and of gemcitabine in patients with advanced biliary cancer. Oncology 56:177–180CrossRefPubMed Raderer M, Hejna MH, Valencak JB, Kornek GV, Weinlander GS, Bareck E, Lenauer J, Brodowicz T, Lang F, Scheithauer W (1999) Two consecutive phase II studies of 5-fluorouracil/leucovorin/mitomycin C and of gemcitabine in patients with advanced biliary cancer. Oncology 56:177–180CrossRefPubMed
go back to reference Sanz-Altamira PM, Ferrante K, Jenkins RL, Lewis WD, Huberman MS, Stuart KE (1998) Phase II trial of 5-fluorouracil, leucovorin, and carboplatin in patients with unresectable biliary tree carcinoma. Cancer 82:2321–2325CrossRefPubMed Sanz-Altamira PM, Ferrante K, Jenkins RL, Lewis WD, Huberman MS, Stuart KE (1998) Phase II trial of 5-fluorouracil, leucovorin, and carboplatin in patients with unresectable biliary tree carcinoma. Cancer 82:2321–2325CrossRefPubMed
go back to reference Seo BN, Chung JH, Chung ID (1995) Clinical aspects for treatment of cholangiocarcinoma in Korea. Proc Korean Cancer Assoc S107:130 Seo BN, Chung JH, Chung ID (1995) Clinical aspects for treatment of cholangiocarcinoma in Korea. Proc Korean Cancer Assoc S107:130
go back to reference Shimada M, Takenaka K, Kawahara N, Yamamoto K, Shirabe K, Maehara Y, Sugimachi K (1996) Chemosensitivity in primary liver cancers: evaluation of the correlation between chemosensitivity and clinicopathological factors. Hepatogastroenterology 43:1159–1164PubMed Shimada M, Takenaka K, Kawahara N, Yamamoto K, Shirabe K, Maehara Y, Sugimachi K (1996) Chemosensitivity in primary liver cancers: evaluation of the correlation between chemosensitivity and clinicopathological factors. Hepatogastroenterology 43:1159–1164PubMed
go back to reference Tanaka N, Yamakado K, Nakaatsuka A, Fujii A, Maatsumura K, Takeda K (2002) Arterial chemoinfusion therapy through an implanted port system for patients with unresectable intrahepatic cholangiocarcinoma: initial experience. Eur J Radiol 41:42–48CrossRefPubMed Tanaka N, Yamakado K, Nakaatsuka A, Fujii A, Maatsumura K, Takeda K (2002) Arterial chemoinfusion therapy through an implanted port system for patients with unresectable intrahepatic cholangiocarcinoma: initial experience. Eur J Radiol 41:42–48CrossRefPubMed
Metadata
Title
Epirubicin, cisplatin, and protracted infusion of 5-FU (ECF) in advanced intrahepatic cholangiocarcinoma
Authors
Myung Ah Lee
In Sook Woo
Jin-Hyoung Kang
Young Seon Hong
Kyung Shik Lee
Publication date
01-06-2004
Publisher
Springer-Verlag
Published in
Journal of Cancer Research and Clinical Oncology / Issue 6/2004
Print ISSN: 0171-5216
Electronic ISSN: 1432-1335
DOI
https://doi.org/10.1007/s00432-003-0534-7

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