Omitting 5-FU Bolus Does Not Reduce Survival in Advanced Cancer

TUESDAY, Sept. 10, 2024 (HealthDay News) — Omission of 5-fluorouracil (5-FU) from the first-line FOLFOX, FOLFIRI, and FOLFIRINOX regimens is not associated with reduced survival among patients with advanced colorectal, gastroesophageal, and pancreatic cancers, according to a study published online Sept. 5 in the Journal of the National Comprehensive Cancer Network.

Chengwei Peng, M.D., from New York University in New York City, and colleagues queried a real-world database for patients with advanced colorectal, gastroesophageal, and pancreatic cancers (8,670, 1,481, and 1,614 patients, respectively) who received first-line FOLFOX, FOLFIRI, and FOLFIRINOX regimens to examine whether omission of the 5-FU bolus is associated with a difference in survival and toxicity.

Overall, 86.3 and 13.7 percent of patients received and did not receive a 5-FU bolus, respectively. The researchers found that omitting the bolus was not associated with a reduction in overall survival after inverse probability of treatment-weighted analysis. However, there were significant associations for bolus omission with reductions in neutropenia (10.7 versus 22.7 percent), thrombocytopenia (11.2 versus 16.1 percent), and use of granulocyte colony-stimulating factor (19.6 versus 29.1 percent) after treatment.

“Our data suggest that omitting the 5-FU bolus may lead to reduced treatment toxicity without compromising efficacy. Future prospective studies are needed to confirm these findings, especially applicability to the adjuvant setting,” the authors write.

Several authors disclosed ties to the biopharmaceutical industry.

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