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A retrospective analysis of plasma concentration monitoring of fluorouracil in patients with advanced colorectal cancer
  1. Quanliang Yang1,
  2. Yanzhi Bi1,
  3. Xiaoqian Li1,
  4. Qian Liu2,
  5. Jian Ma1,
  6. Chengliang Zhang3,
  7. Jinlin Zhang4,
  8. Guangzhao He5
  1. 1 Oncology, Changzhou Cancer Hospital, Soochow University, Changzhou, China
  2. 2 Laboratory Medicine, Changzhou Cancer Hospital, Soochow University, Changzhou, China
  3. 3 Pharmacy, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
  4. 4 Pharmacy, Affiliated Cancer Hospital of Nantong University, Nantong, China
  5. 5 Pharmacy, Changzhou Cancer Hospital, Soochow University, Changzhou, China
  1. Correspondence to Dr Guangzhao He, Pharmacy, Changzhou Cancer Hospital, Soochow University, Changzhou 213032, China; shmily_hgzhao{at}hotmail.com

Abstract

Objectives To analyse the results of fluorouracil (5-FU) plasma concentration monitoring in patients with advanced colorectal cancer after 5-FU treatment, and to provide a reference for the application prospect of 5-FU plasma concentration monitoring technology.

Methods A retrospective analysis was performed with advanced colorectal cancer patients treated with 5-FU from March 2015 to August 2018. The results of plasma concentration monitoring of 5-FU, severe adverse reactions, and anti-tumour efficacy were analysed.

Results Among 47 patients, 5-FU plasma concentration monitoring was carried out a total of 289 times. The area under the receiver operating characteristic (ROC) curve (AUC) reflecting 5-FU exposure in vivo was 2.8–158 mg*h/L (41±94.6 mg*h/L). Mean AUC range within the target range (20–30 mg*h/L) for each patient was observed in 28.8% of patients. The overall incidence of related severe adverse reactions in the AUC ≤30 mg*h/L group was lower than that in the >30 mg*h/L group (24.0% and 50.0%, respectively) (p=0.06), and the incidence of severe neutropenia was 12.0% and 40.9%, respectively (p=0.05). The disease control rate and overall response rate of the AUC <20 mg*h/L group was lower than that of the ≥20 mg*h/L group: 83.3% vs 97.1% (p=0.19) and 25.0% vs 51.4% (p = 0.10), respectively.

Conclusions The 5-FU plasma concentration monitoring technique can improve the safety and efficacy of 5-FU administration to advanced colorectal cancer patients. It is expected to become an important means to individualise 5-FU use in the Chinese population.

  • fluorouracil
  • therapeutic drug monitoring
  • advanced colorectal cancer
  • relative dose intensity

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