Prolonged intraperitoneal infusion of 5-fluorouracil using a novel carrier solution

Br J Cancer. 1996 Dec;74(12):2032-5. doi: 10.1038/bjc.1996.672.

Abstract

A novel peritoneal carrier solution, Icodextrin 20 (7.5%), has allowed exploration of prolonged, intraperitoneal (i.p.) infusion of the cytotoxic drug 5-fluorouracil (5-FU). A phase I and pharmacokinetic study was performed to determine the toxicities and maximum tolerated dose of prolonged and continuous intraperitoneal 5-FU in patients with peritoneal carcinomatosis. Seventeen patients were entered into this study. Each patient had a Tenckhoff catheter placed into the peritoneal cavity under general anaesthetic. After initial flushing and gradual increase in exchange volumes with Icodextrin 20, 5-FU was administered daily from Monday to Friday, 50% as a bolus in the exchange bag and 50% in an elastomeric infusor device delivering continuous 5-FU to the peritoneal cavity at 2 ml h-1. Treatment was continued for 12 weeks or until intolerable toxicity developed. Abdominal pain and infective peritonitis proved to be the main dose-limiting toxicities. Initial problems with infective peritonitis were overcome by redesign of the delivery system, and it proved possible to deliver 300 mg m-2 5-FU daily (5 days per week) for 12 weeks. Pharmacokinetic studies showed i.p. steady-state 5-FU concentrations (mean 47 500 ng ml-1) that were > 1000-fold higher than systemic venous levels (mean 30 ng ml-1).

Publication types

  • Clinical Trial
  • Clinical Trial, Phase I
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Antimetabolites, Antineoplastic / administration & dosage*
  • Antimetabolites, Antineoplastic / pharmacokinetics
  • Drug Carriers
  • Drug Delivery Systems / instrumentation*
  • Female
  • Fluorouracil / administration & dosage*
  • Fluorouracil / pharmacokinetics
  • Follow-Up Studies
  • Humans
  • Infusions, Parenteral
  • Male
  • Middle Aged
  • Peritoneal Dialysis / methods
  • Peritoneal Neoplasms / drug therapy*

Substances

  • Antimetabolites, Antineoplastic
  • Drug Carriers
  • Fluorouracil