Limits...
Raltitrexed treatment promotes systemic inflammatory reaction in patients with colorectal carcinoma.

Osterlund P, Orpana A, Elomaa I, Repo H, Joensuu H - Br. J. Cancer (2002)

Bottom Line: Thirty-nine (75%) of these patients had fever on days 2 to 9 after receiving raltitrexed, 49 (94%) had fatigue Gr. > or = 1, and 49 (94%) elevated S-CRP without a documented infection.The systemic inflammatory composite score (consists of body temperature, fatigue, S-CRP, interleukin-6 (S-IL-6), S-IL-8, and tumour necrosis factor-alpha (S-TNF alpha) levels) was calculated in a cross-sectional one-cycle study involving 60 colorectal cancer patients treated with single-agent raltitrexed, raltitrexed and carmofur, or 5-fluorouracil-based chemotherapy (n=20 in each group).The median S-CRP, S-IL-6, and S-TNF alpha levels were higher 7 days after giving raltitrexed (57 vs 23 mg l(-1), 64 vs 10 ng l(-1), and 11 vs 10 ng l(-1), respectively) or raltitrexed+carmofur (142 vs 10 mg l(-1), 64 vs 10 ng l(-1), and 16 vs 9 ng l(-1), respectively) than at baseline (P<0.01 for each comparison), but not when 5-fluorouracil-based regimens were administered.

View Article: PubMed Central - PubMed

Affiliation: Department of Oncology, Helsinki University Central Hospital, Haartmaninkatu 4, FIN-00029 Helsinki, Finland. pia.osterlund@hus.fi

ABSTRACT
We studied longitudinally inflammatory reactions and serum C-reactive protein (S-CRP) levels in 52 colorectal cancer patients treated with a median of six 3-weekly cycles of raltitrexed 1.5-3.0 mg m(-2) combined with oral carmofur (1-hexylcarbomoyl-5-fluorouracil) 300-400 mg m(-2) on cycle days 2-14. Thirty-nine (75%) of these patients had fever on days 2 to 9 after receiving raltitrexed, 49 (94%) had fatigue Gr. > or = 1, and 49 (94%) elevated S-CRP without a documented infection. The systemic inflammatory composite score (consists of body temperature, fatigue, S-CRP, interleukin-6 (S-IL-6), S-IL-8, and tumour necrosis factor-alpha (S-TNF alpha) levels) was calculated in a cross-sectional one-cycle study involving 60 colorectal cancer patients treated with single-agent raltitrexed, raltitrexed and carmofur, or 5-fluorouracil-based chemotherapy (n=20 in each group). The median S-CRP, S-IL-6, and S-TNF alpha levels were higher 7 days after giving raltitrexed (57 vs 23 mg l(-1), 64 vs 10 ng l(-1), and 11 vs 10 ng l(-1), respectively) or raltitrexed+carmofur (142 vs 10 mg l(-1), 64 vs 10 ng l(-1), and 16 vs 9 ng l(-1), respectively) than at baseline (P<0.01 for each comparison), but not when 5-fluorouracil-based regimens were administered. These findings suggest that colorectal cancer patients treated with raltitrexed may develop drug-related systemic inflammation, which may be difficult to discriminate from infection.

Show MeSH

Related in: MedlinePlus

Serum levels of CRP, IL-6, IL-8, and TNFα of 59 patients in the cross-sectional study. The symbols and cycles are as in Figure 3.
© Copyright Policy
Related In: Results  -  Collection


getmorefigures.php?uid=PMC2364241&req=5

fig4: Serum levels of CRP, IL-6, IL-8, and TNFα of 59 patients in the cross-sectional study. The symbols and cycles are as in Figure 3.

Mentions: The median serum CRP, IL-6, IL-8, and TNFα levels were higher 7 days after starting raltitrexed and carmofur therapy as compared to the precycle levels (142 vs 10 mg l−1 64 vs 10 ng l−1, 21 vs 11 ng l−1, and 16 vs 9 ng l−1, respectively, P<0.001 for each comparison). Similarly, the median serum levels of CRP, IL-6, and TNFα were significantly higher on the cycle day 7 as compared with the precycle levels after commencing single-agent raltitrexed (57 vs 23 mg l−1, 64 vs 10 ng l−1, and 11 vs 10 ng l−1, respectively, P<0.01 for each comparison), but no similar effect was found for IL-8 (22 vs 21 ng l−1). In contrast, patients treated with the 5-FU-based regimens had unchanged serum levels of CRP (6 vs 7 mg l−1), IL-6 (9 vs 7 ng l−1), TNFα (9 vs 9 ng l−1), and IL-8 (7 vs 7 ng l−1). The increases in the serum cytokine levels were more marked in patients who had received more than one cycle of raltitrexed-containing therapies than in those who were assessed during the first chemotherapy cycle (Figure 4Figure 4


Raltitrexed treatment promotes systemic inflammatory reaction in patients with colorectal carcinoma.

Osterlund P, Orpana A, Elomaa I, Repo H, Joensuu H - Br. J. Cancer (2002)

Serum levels of CRP, IL-6, IL-8, and TNFα of 59 patients in the cross-sectional study. The symbols and cycles are as in Figure 3.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2364241&req=5

fig4: Serum levels of CRP, IL-6, IL-8, and TNFα of 59 patients in the cross-sectional study. The symbols and cycles are as in Figure 3.
Mentions: The median serum CRP, IL-6, IL-8, and TNFα levels were higher 7 days after starting raltitrexed and carmofur therapy as compared to the precycle levels (142 vs 10 mg l−1 64 vs 10 ng l−1, 21 vs 11 ng l−1, and 16 vs 9 ng l−1, respectively, P<0.001 for each comparison). Similarly, the median serum levels of CRP, IL-6, and TNFα were significantly higher on the cycle day 7 as compared with the precycle levels after commencing single-agent raltitrexed (57 vs 23 mg l−1, 64 vs 10 ng l−1, and 11 vs 10 ng l−1, respectively, P<0.01 for each comparison), but no similar effect was found for IL-8 (22 vs 21 ng l−1). In contrast, patients treated with the 5-FU-based regimens had unchanged serum levels of CRP (6 vs 7 mg l−1), IL-6 (9 vs 7 ng l−1), TNFα (9 vs 9 ng l−1), and IL-8 (7 vs 7 ng l−1). The increases in the serum cytokine levels were more marked in patients who had received more than one cycle of raltitrexed-containing therapies than in those who were assessed during the first chemotherapy cycle (Figure 4Figure 4

Bottom Line: Thirty-nine (75%) of these patients had fever on days 2 to 9 after receiving raltitrexed, 49 (94%) had fatigue Gr. > or = 1, and 49 (94%) elevated S-CRP without a documented infection.The systemic inflammatory composite score (consists of body temperature, fatigue, S-CRP, interleukin-6 (S-IL-6), S-IL-8, and tumour necrosis factor-alpha (S-TNF alpha) levels) was calculated in a cross-sectional one-cycle study involving 60 colorectal cancer patients treated with single-agent raltitrexed, raltitrexed and carmofur, or 5-fluorouracil-based chemotherapy (n=20 in each group).The median S-CRP, S-IL-6, and S-TNF alpha levels were higher 7 days after giving raltitrexed (57 vs 23 mg l(-1), 64 vs 10 ng l(-1), and 11 vs 10 ng l(-1), respectively) or raltitrexed+carmofur (142 vs 10 mg l(-1), 64 vs 10 ng l(-1), and 16 vs 9 ng l(-1), respectively) than at baseline (P<0.01 for each comparison), but not when 5-fluorouracil-based regimens were administered.

View Article: PubMed Central - PubMed

Affiliation: Department of Oncology, Helsinki University Central Hospital, Haartmaninkatu 4, FIN-00029 Helsinki, Finland. pia.osterlund@hus.fi

ABSTRACT
We studied longitudinally inflammatory reactions and serum C-reactive protein (S-CRP) levels in 52 colorectal cancer patients treated with a median of six 3-weekly cycles of raltitrexed 1.5-3.0 mg m(-2) combined with oral carmofur (1-hexylcarbomoyl-5-fluorouracil) 300-400 mg m(-2) on cycle days 2-14. Thirty-nine (75%) of these patients had fever on days 2 to 9 after receiving raltitrexed, 49 (94%) had fatigue Gr. > or = 1, and 49 (94%) elevated S-CRP without a documented infection. The systemic inflammatory composite score (consists of body temperature, fatigue, S-CRP, interleukin-6 (S-IL-6), S-IL-8, and tumour necrosis factor-alpha (S-TNF alpha) levels) was calculated in a cross-sectional one-cycle study involving 60 colorectal cancer patients treated with single-agent raltitrexed, raltitrexed and carmofur, or 5-fluorouracil-based chemotherapy (n=20 in each group). The median S-CRP, S-IL-6, and S-TNF alpha levels were higher 7 days after giving raltitrexed (57 vs 23 mg l(-1), 64 vs 10 ng l(-1), and 11 vs 10 ng l(-1), respectively) or raltitrexed+carmofur (142 vs 10 mg l(-1), 64 vs 10 ng l(-1), and 16 vs 9 ng l(-1), respectively) than at baseline (P<0.01 for each comparison), but not when 5-fluorouracil-based regimens were administered. These findings suggest that colorectal cancer patients treated with raltitrexed may develop drug-related systemic inflammation, which may be difficult to discriminate from infection.

Show MeSH
Related in: MedlinePlus