1. ¹Department of Medical Oncology, Prince of Wales Hospital, Randwick, Sydney, NSW 2031, Australia
2. ²Department of Medical Oncology, Austin and Repatriation Medical Centre, Melbourne, Australia
3. ³Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
4. ⁴Department of Medical Oncology, Royal Prince Alfred Hospital, Sydney, Australia

Correspondence: Dr D Goldstein, E-mail: d.goldstein@unsw.edu.au

Revised 1 November 2004; Accepted 21 December 2004; Published online 1 March 2005.

Abstract

This study determined the efficacy and safety of a modified FOLFOX regimen that improved patient convenience without compromising oxaliplatin dose intensity. A total of 62 patients with previously untreated metastatic colorectal cancer were enrolled to receive, entirely as outpatients, 2-weekly cycles of oxaliplatin 100 mg m^-2 i.v. over 2 h, together with leucovorin 400 mg m^-2 over 2 h, 5-fluorouracil (5-FU) 400 mg m^-2, bolus, followed by a 46-h infusion of 5-FU at 2.4 g m^-2. Treatment was given until progression or unmanageable toxicity. In all, 61 patients received one oxaliplatin dose and a median of 11 treatment cycles (range 1–20 cycles); 22 (36%) reported grade 3/4 neutropenia and 13 patients (21%) experienced grade 3 neurotoxicity; 16 patients (26%) discontinued treatment due to disease progression or death, 15 (25%) due to neurotoxicity and six (10%) due to haematological toxicity. Of the 56 eligible patients, complete or partial responses were observed in 29 or 52% (95% confidence interval 38–65%). Median progression-free survival was 8.2 months (7.1–9.9) and median overall survival was 18.7 months (14.0–23.4). In our experience, a modified schedule of FOLFOX improves convenience without compromising efficacy or toxicity.