Folinic acid in colorectal cancer: esquire or fellow knight? Real-world results from a mono institutional, retrospective study
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Francesco Jacopo Romano1, Carmela Barbato1, Maria Biglietto1, Vincenzo Di Lauro2, Dario Arundine2, Roberto Fiorentino1, Francesca Ambrosio1, Maresa Cammarota3, Bruno Chiurazzi1, Livio Puglia1, Sarah Scagliarini1, Raffaella Ruocco1, Carmen Mocerino1, Ivana Cerillo1, Maria Fiorella Brangi1 and Ferdinando Riccardi1
1 Antonio Cardarelli Hospital, Oncology Unit, Naples, Italy
2 Federico II University, Department of Medicine and Surgery, Oncology Unit, Naples, Italy
3 Antonio Cardarelli Hospital, Pharmacy Unit, Naples, Italy
|Francesco Jacopo Romano,||email:||[email protected]|
Keywords: colorectal cancer; folinic acid; sodium levofolinate; thymidylate synthase; non oncogene addiction
Received: September 28, 2020 Accepted: January 07, 2021 Published: February 02, 2021
The stock of therapeutic weapons available in metastatic colorectal cancer (mCRC) has been progressively grown over the years, with improving both survival and patients' clinical outcome: notwithstanding advances in the knowledge of mCRC biology, as well as advances in treatment, fluoropyrimidine antimetabolite drugs have been for 30 years the mainstay of chemotherapy protocols for this malignancy. 5-Fluorouracil (5FU) seems to act differently depending on administration method: elastomer-mediated continuous infusion better inhibits Thymidylate Synthase (TS), an enzyme playing a pivotal role in DNA synthetic pathway. TS overexpression is an acknowledged poor prognosis predicting factor. The simultaneous combination of 5FU and folinate salt synergistically strengthens fluorouracil cytotoxic effect. In our experience, levofolinate and 5FU together in continuous infusion prolong progression free survival of patients suffering from mCRC, moreover decreasing death risk and showing a clear clinical benefit for patients, irrespective of RAS mutational status, primitive tumor side and metastases surgery.
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