Treatment of carcinoma of the esophagus with 5-fluorouracil and recombinant alfa-2a-interferon

S. Wadler, S. Fell, Hilda Haynes-Lewis, H. J. Katz, Alla Rozenblit, R. Kaleya, P. H. Wiernik

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Background. Combinations of 5-fluorouracil (5FU) and recombinant alfa-2a- interferon (IFN) are synergistic in vitro and have demonstrated activity in colorectal carcinoma, renal cell carcinoma, and urothelial tumors. Methods. A Phase II trial of the combination of 5FU, 750 mg/m2 daily x 5 followed by weekly bolus therapy, and IFN, 9 MU subcutaneously three times per week, was initiated in patients with esophageal carcinomas. Patients were required to have biopsy-proven squamous cell or adenocarcinoma of the esophagus, locally advanced or metastatic disease beyond the scope of surgical resection, and adequate performance status, renal, hepatic, and bone marrow function. Results. Twenty-one patients were enrolled; one patient was inevaluable for response because he had received prior chemotherapy, but was evaluated for toxicity. Eleven patients had metastatic disease, and 10 had locally advanced disease. Thirteen patients had squamous cell carcinoma and 8 adenocarcinoma. Toxicities were acceptable with no serious diarrhea and only two cases of serious stomatitis, although a greater than expected incidence of neurologic toxicity was observed. There were five responders (25%) including two patients with advanced or locally advanced disease rendered pathologically free of disease. One patient, initially considered surgically unresectable, was able to undergo a total thoracic esophagectomy after responding to treatment with 5FU/IFN, at which time only a single microscopic focus of carcinoma in situ was found. She remains alive and free of disease at 18+ months. A second patient who presented with metastatic disease and nearly complete obstruction of the esophagus regained normal swallowing function after treatment with 5FU/IFN; rebiopsy of all lesions revealed the patient to be pathologically free of disease. He survived over 2 years. Conclusions. This regimen employing a single cytotoxic agent has activity in esophageal carcinoma. Strategies employing biochemical modulation deserve additional investigation in the treatment of esophageal carcinoma.

Original languageEnglish (US)
Pages (from-to)1726-1730
Number of pages5
JournalCancer
Volume71
Issue number5
StatePublished - 1993

Fingerprint

Fluorouracil
Esophagus
Carcinoma
Interferons
Therapeutics
interferon alfa-2a
Stomatitis
Esophagectomy
Carcinoma in Situ
Cytotoxins
Deglutition
Renal Cell Carcinoma
Nervous System
Squamous Cell Carcinoma
Colorectal Neoplasms
Diarrhea
Adenocarcinoma
Thorax
Bone Marrow
Epithelial Cells

Keywords

  • 5-fluorouracil
  • biochemical modulation
  • esophagus
  • interferon

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Wadler, S., Fell, S., Haynes-Lewis, H., Katz, H. J., Rozenblit, A., Kaleya, R., & Wiernik, P. H. (1993). Treatment of carcinoma of the esophagus with 5-fluorouracil and recombinant alfa-2a-interferon. Cancer, 71(5), 1726-1730.

Treatment of carcinoma of the esophagus with 5-fluorouracil and recombinant alfa-2a-interferon. / Wadler, S.; Fell, S.; Haynes-Lewis, Hilda; Katz, H. J.; Rozenblit, Alla; Kaleya, R.; Wiernik, P. H.

In: Cancer, Vol. 71, No. 5, 1993, p. 1726-1730.

Research output: Contribution to journalArticle

Wadler, S, Fell, S, Haynes-Lewis, H, Katz, HJ, Rozenblit, A, Kaleya, R & Wiernik, PH 1993, 'Treatment of carcinoma of the esophagus with 5-fluorouracil and recombinant alfa-2a-interferon', Cancer, vol. 71, no. 5, pp. 1726-1730.
Wadler S, Fell S, Haynes-Lewis H, Katz HJ, Rozenblit A, Kaleya R et al. Treatment of carcinoma of the esophagus with 5-fluorouracil and recombinant alfa-2a-interferon. Cancer. 1993;71(5):1726-1730.
Wadler, S. ; Fell, S. ; Haynes-Lewis, Hilda ; Katz, H. J. ; Rozenblit, Alla ; Kaleya, R. ; Wiernik, P. H. / Treatment of carcinoma of the esophagus with 5-fluorouracil and recombinant alfa-2a-interferon. In: Cancer. 1993 ; Vol. 71, No. 5. pp. 1726-1730.
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abstract = "Background. Combinations of 5-fluorouracil (5FU) and recombinant alfa-2a- interferon (IFN) are synergistic in vitro and have demonstrated activity in colorectal carcinoma, renal cell carcinoma, and urothelial tumors. Methods. A Phase II trial of the combination of 5FU, 750 mg/m2 daily x 5 followed by weekly bolus therapy, and IFN, 9 MU subcutaneously three times per week, was initiated in patients with esophageal carcinomas. Patients were required to have biopsy-proven squamous cell or adenocarcinoma of the esophagus, locally advanced or metastatic disease beyond the scope of surgical resection, and adequate performance status, renal, hepatic, and bone marrow function. Results. Twenty-one patients were enrolled; one patient was inevaluable for response because he had received prior chemotherapy, but was evaluated for toxicity. Eleven patients had metastatic disease, and 10 had locally advanced disease. Thirteen patients had squamous cell carcinoma and 8 adenocarcinoma. Toxicities were acceptable with no serious diarrhea and only two cases of serious stomatitis, although a greater than expected incidence of neurologic toxicity was observed. There were five responders (25{\%}) including two patients with advanced or locally advanced disease rendered pathologically free of disease. One patient, initially considered surgically unresectable, was able to undergo a total thoracic esophagectomy after responding to treatment with 5FU/IFN, at which time only a single microscopic focus of carcinoma in situ was found. She remains alive and free of disease at 18+ months. A second patient who presented with metastatic disease and nearly complete obstruction of the esophagus regained normal swallowing function after treatment with 5FU/IFN; rebiopsy of all lesions revealed the patient to be pathologically free of disease. He survived over 2 years. Conclusions. This regimen employing a single cytotoxic agent has activity in esophageal carcinoma. Strategies employing biochemical modulation deserve additional investigation in the treatment of esophageal carcinoma.",
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T1 - Treatment of carcinoma of the esophagus with 5-fluorouracil and recombinant alfa-2a-interferon

AU - Wadler, S.

AU - Fell, S.

AU - Haynes-Lewis, Hilda

AU - Katz, H. J.

AU - Rozenblit, Alla

AU - Kaleya, R.

AU - Wiernik, P. H.

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N2 - Background. Combinations of 5-fluorouracil (5FU) and recombinant alfa-2a- interferon (IFN) are synergistic in vitro and have demonstrated activity in colorectal carcinoma, renal cell carcinoma, and urothelial tumors. Methods. A Phase II trial of the combination of 5FU, 750 mg/m2 daily x 5 followed by weekly bolus therapy, and IFN, 9 MU subcutaneously three times per week, was initiated in patients with esophageal carcinomas. Patients were required to have biopsy-proven squamous cell or adenocarcinoma of the esophagus, locally advanced or metastatic disease beyond the scope of surgical resection, and adequate performance status, renal, hepatic, and bone marrow function. Results. Twenty-one patients were enrolled; one patient was inevaluable for response because he had received prior chemotherapy, but was evaluated for toxicity. Eleven patients had metastatic disease, and 10 had locally advanced disease. Thirteen patients had squamous cell carcinoma and 8 adenocarcinoma. Toxicities were acceptable with no serious diarrhea and only two cases of serious stomatitis, although a greater than expected incidence of neurologic toxicity was observed. There were five responders (25%) including two patients with advanced or locally advanced disease rendered pathologically free of disease. One patient, initially considered surgically unresectable, was able to undergo a total thoracic esophagectomy after responding to treatment with 5FU/IFN, at which time only a single microscopic focus of carcinoma in situ was found. She remains alive and free of disease at 18+ months. A second patient who presented with metastatic disease and nearly complete obstruction of the esophagus regained normal swallowing function after treatment with 5FU/IFN; rebiopsy of all lesions revealed the patient to be pathologically free of disease. He survived over 2 years. Conclusions. This regimen employing a single cytotoxic agent has activity in esophageal carcinoma. Strategies employing biochemical modulation deserve additional investigation in the treatment of esophageal carcinoma.

AB - Background. Combinations of 5-fluorouracil (5FU) and recombinant alfa-2a- interferon (IFN) are synergistic in vitro and have demonstrated activity in colorectal carcinoma, renal cell carcinoma, and urothelial tumors. Methods. A Phase II trial of the combination of 5FU, 750 mg/m2 daily x 5 followed by weekly bolus therapy, and IFN, 9 MU subcutaneously three times per week, was initiated in patients with esophageal carcinomas. Patients were required to have biopsy-proven squamous cell or adenocarcinoma of the esophagus, locally advanced or metastatic disease beyond the scope of surgical resection, and adequate performance status, renal, hepatic, and bone marrow function. Results. Twenty-one patients were enrolled; one patient was inevaluable for response because he had received prior chemotherapy, but was evaluated for toxicity. Eleven patients had metastatic disease, and 10 had locally advanced disease. Thirteen patients had squamous cell carcinoma and 8 adenocarcinoma. Toxicities were acceptable with no serious diarrhea and only two cases of serious stomatitis, although a greater than expected incidence of neurologic toxicity was observed. There were five responders (25%) including two patients with advanced or locally advanced disease rendered pathologically free of disease. One patient, initially considered surgically unresectable, was able to undergo a total thoracic esophagectomy after responding to treatment with 5FU/IFN, at which time only a single microscopic focus of carcinoma in situ was found. She remains alive and free of disease at 18+ months. A second patient who presented with metastatic disease and nearly complete obstruction of the esophagus regained normal swallowing function after treatment with 5FU/IFN; rebiopsy of all lesions revealed the patient to be pathologically free of disease. He survived over 2 years. Conclusions. This regimen employing a single cytotoxic agent has activity in esophageal carcinoma. Strategies employing biochemical modulation deserve additional investigation in the treatment of esophageal carcinoma.

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