A phase I/II study of trimetrexate and capecitabine in patients with advanced refractory colorectal cancer

Khalid Matin, Samuel A. Jacobs, Thomas Richards, Michael K. Wong, Martin Earle, Terry Evans, Monica Troetschel, William Ferri, David Friedland, Richard Pinkerton, Robert Volkin, Samuel Wieand, Ramesk K Ramanathan

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Objective: We tested the hypothesis that the combination of trimetrexate (TMTX) and capecitabine (CAP) would be active in patients with previously treated metastatic colorectal cancer (CRC). Because the optimum dose of this combination was unknown, we used a phase I/II design. Methods: In the phase I cohort, patients received 110 mg/m2 TMTX intravenously weekly ×6 and CAP starting at 750 mg/m2 orally twice daily from days 2 to 15 and 23 to 36 (one cycle). Cycles were repeated every 8 weeks. The phase II doses were 110 mg/m2 TMTX and 1000 mg/m2 CAP orally twice daily. Results: Thirty-two patients were entered. All patients had prior 5-fluorouracil therapy and 94% had prior exposure to irinotecan. Grade 3/4 toxicities included abdominal pain in 4 patients (12.5%) and vomiting in 3 patients (9.4%). Twenty-seven patients were evaluable for response: one patient each had a complete response and a partial response for an overall response rate of 7.4%. The median time to progression was 3.3 months (95% confidence interval [CI], 1.6-3.7 months) and the median overall survival was 5.9 months (95% CI, 5.2-10.2 months). Conclusions: The combination of TMTX and CAP is well tolerated. However, recent studies have shown more active regimens in the second- and third-line metastatic setting.

Original languageEnglish (US)
Pages (from-to)439-444
Number of pages6
JournalAmerican Journal of Clinical Oncology: Cancer Clinical Trials
Volume28
Issue number5
DOIs
StatePublished - Oct 2005
Externally publishedYes

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Trimetrexate
Colorectal Neoplasms
irinotecan
Confidence Intervals
Capecitabine
Fluorouracil
Abdominal Pain
Vomiting

Keywords

  • Capecitabine
  • Colorectal cancer
  • Trimetrexate

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

A phase I/II study of trimetrexate and capecitabine in patients with advanced refractory colorectal cancer. / Matin, Khalid; Jacobs, Samuel A.; Richards, Thomas; Wong, Michael K.; Earle, Martin; Evans, Terry; Troetschel, Monica; Ferri, William; Friedland, David; Pinkerton, Richard; Volkin, Robert; Wieand, Samuel; Ramanathan, Ramesk K.

In: American Journal of Clinical Oncology: Cancer Clinical Trials, Vol. 28, No. 5, 10.2005, p. 439-444.

Research output: Contribution to journalArticle

Matin, K, Jacobs, SA, Richards, T, Wong, MK, Earle, M, Evans, T, Troetschel, M, Ferri, W, Friedland, D, Pinkerton, R, Volkin, R, Wieand, S & Ramanathan, RK 2005, 'A phase I/II study of trimetrexate and capecitabine in patients with advanced refractory colorectal cancer', American Journal of Clinical Oncology: Cancer Clinical Trials, vol. 28, no. 5, pp. 439-444. https://doi.org/10.1097/01.coc.0000170797.36351.3a
Matin, Khalid ; Jacobs, Samuel A. ; Richards, Thomas ; Wong, Michael K. ; Earle, Martin ; Evans, Terry ; Troetschel, Monica ; Ferri, William ; Friedland, David ; Pinkerton, Richard ; Volkin, Robert ; Wieand, Samuel ; Ramanathan, Ramesk K. / A phase I/II study of trimetrexate and capecitabine in patients with advanced refractory colorectal cancer. In: American Journal of Clinical Oncology: Cancer Clinical Trials. 2005 ; Vol. 28, No. 5. pp. 439-444.
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AU - Jacobs, Samuel A.

AU - Richards, Thomas

AU - Wong, Michael K.

AU - Earle, Martin

AU - Evans, Terry

AU - Troetschel, Monica

AU - Ferri, William

AU - Friedland, David

AU - Pinkerton, Richard

AU - Volkin, Robert

AU - Wieand, Samuel

AU - Ramanathan, Ramesk K

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N2 - Objective: We tested the hypothesis that the combination of trimetrexate (TMTX) and capecitabine (CAP) would be active in patients with previously treated metastatic colorectal cancer (CRC). Because the optimum dose of this combination was unknown, we used a phase I/II design. Methods: In the phase I cohort, patients received 110 mg/m2 TMTX intravenously weekly ×6 and CAP starting at 750 mg/m2 orally twice daily from days 2 to 15 and 23 to 36 (one cycle). Cycles were repeated every 8 weeks. The phase II doses were 110 mg/m2 TMTX and 1000 mg/m2 CAP orally twice daily. Results: Thirty-two patients were entered. All patients had prior 5-fluorouracil therapy and 94% had prior exposure to irinotecan. Grade 3/4 toxicities included abdominal pain in 4 patients (12.5%) and vomiting in 3 patients (9.4%). Twenty-seven patients were evaluable for response: one patient each had a complete response and a partial response for an overall response rate of 7.4%. The median time to progression was 3.3 months (95% confidence interval [CI], 1.6-3.7 months) and the median overall survival was 5.9 months (95% CI, 5.2-10.2 months). Conclusions: The combination of TMTX and CAP is well tolerated. However, recent studies have shown more active regimens in the second- and third-line metastatic setting.

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