Oxaliplatin/Fluorouracil/Leucovorin in Advanced Colorectal Carcinoma: an Asian Experience

BACKGROUND: Oxaliplatin/fluorouracil/leucovorin (FOLFOX4) is an effective and generally well-tolerated regimen in Western studies of metastatic colorectal carcinoma. OBJECTIVE: To evaluate the objective tumor responses and toxicities of the FOLFOX4 regimen in a predominantly Chinese population with advanced colorectal carcinoma in Singapore. METHODS: Forty-seven consecutive patients were enrolled in a retrospective study between March 1998 and December 2001. FOLFOX4 was first-line treatment in 36% of these patients, second-line in 36%, third-line in 17%, and fourth-line in 11%. Tumor responses were assessed radiologically, and toxicities were graded by the National Cancer Institute common toxicity system. RESULTS: The objective response rate (all partial responses) was 45%, and stable disease was achieved in 35% of the patients. There were no deaths due to toxicity. Mild to moderate peripheral sensory neuropathy affected half of the patients, with 1 report of cold exacerbation in this tropical series. The rate of hypersensitivity reactions to oxaliplatin was 11%, and they usually occurred late in the treatment course. CONCLUSIONS: FOLFOX4 has good efficacy in metastatic colorectal carcinoma in our local population, but the rate of hypersensitivity reactions to oxaliplatin was high.