Abstract:
:Regimens based on flouropyrimidines (eg, 5-fluorouracil [5-FU] and capecitabine) are the mainstay of chemotherapy for several malignancies, including colon, pancreatic, upper gastrointestinal, and breast cancers. Warfarin is one of the most commonly used oral anticoagulants. Patients receiving concomitant capecitabine or 5-FU and warfarin have, at times, exhibited altered coagulation parameters and consequent bleeding, even causing death in some cases. Reports have shown clinically significant increases in partial thromboplastin time (PTT) and International Normalized Ratio (INR) in patients whose condition was stabilized with the use of anticoagulants at the time capecitabine or 5-FU was introduced. These alterations in coagulation parameters occurred within several days and for as long several months after initiation of capecitabine or 5-FU therapy and, in a few cases, within a month after stopping capecitabine or 5-FU therapy. These events occurred in patients with and without liver metastases. The inhibition of hepatic metabolism of warfarin by 5-FU was postulated to explain this drug interaction, but the true mechanism and how to monitor it remain under investigation. The US Food and Drug Administration and Roche have added a "Black Box" warning and strengthened the "Precautions" section on the label of capecitabine, which is indicated for the treatment of colorectal and breast cancer. Patients should have their anticoagulant response (INR or PTT) monitored frequently in order to adjust the anticoagulant dose accordingly. The current article includes a review of the literature to describe the interaction between capecitabine or 5-FU and warfarin, its clinical presentation, a comparison between 5-FU and capecitabine interactions, the mechanism of altered coagulation parameters, findings with agents such as uracil/tegafur, and guidelines to monitor the patients simultaneously receiving these agents.
journal_name
Clin Colorectal Cancerjournal_title
Clinical colorectal cancerauthors
Saif MWdoi
10.3816/ccc.2005.n.028keywords:
subject
Has Abstractpub_date
2005-09-01 00:00:00pages
175-80issue
3eissn
1533-0028issn
1938-0674pii
S1533-0028(11)70181-5journal_volume
5pub_type
杂志文章,评审abstract:BACKGROUND:Köhne prognostic score is used to classify patients with metastatic colorectal cancer (mCRC) as high, intermediate, or low risk. Using data from 2 phase III trials, we analyzed survival in patients categorized according to Köhne prognostic category and virus-induced rapidly accelerated fibrosarcoma murine sa...
journal_title:Clinical colorectal cancer
pub_type: 杂志文章
doi:10.1016/j.clcc.2017.09.006
更新日期:2018-03-01 00:00:00
abstract:BACKGROUND:Individually, oxaliplatin and irinotecan have substantial activity in metastatic colorectal cancer (CRC) in combination with 5-fluorouracil/leucovorin. A combination regimen using all 4 agents could potentially increase response rates in CRC. PATIENTS AND METHODS:A multicenter phase II trial of oxaliplatin ...
journal_title:Clinical colorectal cancer
pub_type: 杂志文章,多中心研究
doi:10.3816/CCC.2007.n.017
更新日期:2007-05-01 00:00:00
abstract:UNLABELLED:Two identical randomized controlled trials designed to optimize adjuvant treatment of colon cancer (CC) (n =855) and rectal cancer (RC) (n = 796) were performed. Long-term evaluation confirmed that the addition of folinic acid (FA) to 5-fluorouracil (5-FU) improved 7-year overall survival (OS) in CC but not ...
journal_title:Clinical colorectal cancer
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.clcc.2012.07.005
更新日期:2013-03-01 00:00:00
abstract::Combination protocols of 5-fluorouracil/leucovorin (5-FU/LV) plus irinotecan or oxaliplatin have demonstrated high activity in metastatic colorectal cancer. Capecitabine, an oral 5-FU prodrug, may replace infusional 5-FU/LV in combination protocols with irinotecan or oxaliplatin. We therefore initiated a phase II stud...
journal_title:Clinical colorectal cancer
pub_type: 临床试验,杂志文章
doi:10.3816/ccc.2004.n.009
更新日期:2004-05-01 00:00:00
abstract:BACKGROUND:Metastatic colorectal cancer (CRC) outcomes continue to improve, but they vary significantly by race and ethnicity. We hypothesize that these disparities arise from unequal access to care. MATERIALS AND METHODS:The Harris Health System (HHS) is an integrated health delivery network that provides medical car...
journal_title:Clinical colorectal cancer
pub_type: 杂志文章
doi:10.1016/j.clcc.2019.09.002
更新日期:2020-06-01 00:00:00
abstract::This article reviews the current status of the topoisomerase I (top I) inhibitors in the treatment of gastrointestinal (GI) malignancies. We focus on oral drug administration, the mode of administration that is generally preferred by patients with cancer. However, the great majority of the studies have been performed ...
journal_title:Clinical colorectal cancer
pub_type: 杂志文章,评审
doi:10.3816/ccc.2004.n.017
更新日期:2004-09-01 00:00:00
abstract:BACKGROUND:No biomarkers exist to predict benefit from antiangiogenic therapy in metastatic colorectal cancer patients. ACVRL1 (activin receptor like-protein 1) encodes for ALK1, a member of the transforming growth factor-β receptor family, which directs pathologic angiogenesis. We examined the intratumoral expression ...
journal_title:Clinical colorectal cancer
pub_type: 杂志文章
doi:10.1016/j.clcc.2018.03.006
更新日期:2018-09-01 00:00:00
abstract:PURPOSE:Our purpose is to perform a comprehensive literature review of the use of levoleucovorin in gastrointestinal malignancies and to assess whether levoleucovorin is a reasonable alternative to racemic leucovorin. DESIGN:This is an extensive literature review of levoleucovorin use in patients with gastrointestinal...
journal_title:Clinical colorectal cancer
pub_type: 杂志文章,评审
doi:10.3816/CCC.2009.n.034
更新日期:2009-10-01 00:00:00
abstract:BACKGROUND:In this study, the maximum tolerated dose and toxicity profile of FOLFIRI (infusional fluorouracil [5-FU]/leucovorin/irinotecan) plus gefitinib (an oral inhibitor of the epidermal growth factor receptor) were evaluated as first-line therapy in patients with metastatic colorectal cancer. PATIENTS AND METHODS...
journal_title:Clinical colorectal cancer
pub_type: 杂志文章
doi:10.3816/CCC.2006.n.037
更新日期:2006-09-01 00:00:00
abstract::Thymidylate synthase (TS) is a key enzyme in the synthesis of 2'-deoxythymidine-5'-monophosphate, an essential precursor for DNA biosynthesis. For this reason, this enzyme is a critical target in cancer chemotherapy. As the first TS inhibitor in clinical use, 5-fluorouracil (5-FU) remains widely used for the treatment...
journal_title:Clinical colorectal cancer
pub_type: 杂志文章,评审
doi:10.3816/CCC.2002.n.003
更新日期:2002-02-01 00:00:00
abstract:INTRODUCTION:Patients with metastatic colorectal cancer (CRC) may present with oligometastatic lung lesions for which stereotactic ablative radiotherapy (SABR) can be utilized. This study aims to report efficacy and prognostic factors associated with colorectal lung metastases treated with SABR. MATERIAL AND METHODS:T...
journal_title:Clinical colorectal cancer
pub_type: 杂志文章
doi:10.1016/j.clcc.2016.08.003
更新日期:2017-09-01 00:00:00
abstract::Significant advances have been made with respect to our understanding of the critical role of agents targeting angiogenic pathways in the treatment of metastatic colorectal cancer (mCRC). The approval of 3 agents that target angiogenic signaling, bevacizumab, ziv-aflibercept, and regorafenib, provides strong evidence ...
journal_title:Clinical colorectal cancer
pub_type: 杂志文章,评审
doi:10.1016/j.clcc.2014.02.001
更新日期:2014-09-01 00:00:00
abstract:INTRODUCTION:Hepatic arterial infusion chemotherapy (HAIC) is a treatment used for liver metastases (LM) of colorectal cancer (CRC). Because of its technical conditions, it has been used in only a few experienced centers in France. Our aim was to evaluate its feasibility, efficacy and tolerance in 4 centers. METHODS:C...
journal_title:Clinical colorectal cancer
pub_type: 杂志文章,多中心研究
doi:10.1016/j.clcc.2017.03.003
更新日期:2017-12-01 00:00:00
abstract:BACKGROUND:Similar epidemiologic characteristics suggest a common etiology for colon cancer (CC) and diverticular disease of the colon (DD). The relationship between the 2 diseases is still unclear, and the impact of DD in patients diagnosed with CC on disease-free survival (DFS) and overall survival (OS) is unknown. N...
journal_title:Clinical colorectal cancer
pub_type: 临床试验,杂志文章
doi:10.3816/ccc.2006.n.031
更新日期:2006-07-01 00:00:00
abstract:INTRODUCTION:Bevacizumab improves outcome for patients with advanced colorectal cancer (CRC) when added to chemotherapy. The HORIZON I trial resulted in similar outcome with bevacizumab or cediranib, a small-molecule tyrosine kinase inhibitor of vascular endothelial growth factor (VEGF) receptor, as treatment of advanc...
journal_title:Clinical colorectal cancer
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.clcc.2013.11.002
更新日期:2014-03-01 00:00:00
abstract:INTRODUCTION:The aim of this study was to evaluate the efficacy and safety of maintenance therapy with axitinib versus placebo following induction therapy in patients with metastatic colorectal cancer (mCRC). PATIENTS AND METHODS:In this double-blinded, phase II trial, patients with mCRC who had not progressed after 6...
journal_title:Clinical colorectal cancer
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.clcc.2018.02.004
更新日期:2018-06-01 00:00:00
abstract::Hepatic colorectal metastases present a challenging problem in patients with recurrent colorectal cancer. Twenty percent of patients with recurrence will have liver metastases as a component of their disease, and only 10% of these patients will have isolated liver metastases that are resectable. Although systemic chem...
journal_title:Clinical colorectal cancer
pub_type: 杂志文章,评审
doi:10.3816/CCC.2003.n.010
更新日期:2003-05-01 00:00:00
abstract:BACKGROUND:Adenocarcinoma of the vermiform appendix is rare. It constitutes less than 0.5% of all gastrointestinal malignancies. Pathologically, appendiceal neoplasms are categorized into various subtypes depending on cell lineage. PATIENTS AND METHODS:We considered a case series of appendiceal invasive adenocarcinoma...
journal_title:Clinical colorectal cancer
pub_type: 杂志文章
doi:10.1016/j.clcc.2014.11.003
更新日期:2015-03-01 00:00:00
abstract::Despite an armamentarium that is wide in range, scope of action, and target, chemotherapy has limited success in colorectal cancer (CRC). Novel approaches are needed to overcome tumor barriers to chemotherapy that includes an abnormal tumor vasculature constituting a poor drug delivery system. We have previously shown...
journal_title:Clinical colorectal cancer
pub_type: 杂志文章
doi:10.3816/CCC.2009.n.025
更新日期:2009-07-01 00:00:00
abstract:BACKGROUND:We performed a meta-analysis of previous reports evaluating the effect of mFIO (modified FOLFIRINOX; leucovorin, 5-fluorouracil, irinotecan, oxaliplatin) regimens in advanced pancreatic cancer. MATERIALS AND METHODS:We performed a meta-analysis of reported studies in PubMed, Scopus, and Web of Science (1950...
journal_title:Clinical colorectal cancer
pub_type: 杂志文章,meta分析
doi:10.1016/j.clcc.2018.03.007
更新日期:2018-09-01 00:00:00
abstract::As new improvements in the treatment of colorectal cancer have become available, it has become important to understand the benefits of new therapies or the deleterious effects stemming from the increased risk of toxicity. In particular, a more rational approach to adjuvant chemotherapy for patients with stage II/III d...
journal_title:Clinical colorectal cancer
pub_type: 杂志文章,评审
doi:10.3816/ccc.2006.n.019
更新日期:2006-05-01 00:00:00
abstract::Thymidylate synthase (TS) expression has been identified as an important predictor of response to 5-fluorouracil (5-FU). However, there is relatively little information on the heterogeneity of TS mRNA expression between primary and metastatic tumors, as well as differential expression of TS mRNA in metastatic sites. I...
journal_title:Clinical colorectal cancer
pub_type: 杂志文章
doi:10.3816/CCC.2001.n.017
更新日期:2001-11-01 00:00:00
abstract:BACKGROUND:The safety of bevacizumab in older mCRC patients is poorly understood. The purpose of this analysis was to determine the prevalence, incidence, and risk factors for treatment-related AEs in older bevacizumab recipients. PATIENTS AND METHODS:Patients age ≥65 were identified from SEER-Medicare and categorized...
journal_title:Clinical colorectal cancer
pub_type: 杂志文章
doi:10.1016/j.clcc.2012.11.004
更新日期:2013-09-01 00:00:00
abstract::Bevacizumab is a humanized monoclonal antibody approved by the US Food and Drug Administration for use in combination with fluorouracil (FU)-based chemotherapy for first-line treatment of patients with metastatic colorectal carcinoma (CRC). Its mechanism of action is inhibition of tumor angiogenesis by neutralizing va...
journal_title:Clinical colorectal cancer
pub_type: 杂志文章
doi:10.3816/CCC.2010.n.008
更新日期:2010-01-01 00:00:00
abstract:UNLABELLED:Patients with colorectal cancer (CRC) and renal cell carcinoma (RCC) may be at risk for additional primary malignancies. A review of 101 patients with these concurrent diagnoses was performed. Forty-two percent of patients had 1 or more additional malignancies; none appeared to be associated with Lynch syndr...
journal_title:Clinical colorectal cancer
pub_type: 临床试验,杂志文章
doi:10.1016/j.clcc.2012.07.004
更新日期:2013-03-01 00:00:00
abstract::Epidermal growth factor receptor (EGFR) has been validated as an important target in the treatment of metastatic colorectal cancer (mCRC). While initial studies focused on the treatment of disease that was refractory to available chemotherapy agents, 2 recent themes have emerged: the use of KRAS mutation status to sel...
journal_title:Clinical colorectal cancer
pub_type: 杂志文章,评审
doi:10.3816/CCC.2010.s.006
更新日期:2010-06-01 00:00:00
abstract:PURPOSE:American Society of Clinical Oncology (ASCO) guidelines define high-risk prognostic features (HRFs) in stage II colon cancer and recommend limiting adjuvant chemotherapy to patients with HRFs. We evaluated the extent to which HRFs influenced decisions on adjuvant chemotherapy before and after publication of the...
journal_title:Clinical colorectal cancer
pub_type: 杂志文章
doi:
更新日期:2009-04-01 00:00:00
abstract::Colorectal cancer (CRC) is the second most common cause of cancer-related death in the United States. Despite excellent prognosis for early stage disease, 5-year survival rates in metastatic disease remain low. A small subset of CRC is defined by a deficiency in mismatch repair (dMMR) resulting in high levels of micro...
journal_title:Clinical colorectal cancer
pub_type: 杂志文章,评审
doi:10.1016/j.clcc.2020.02.002
更新日期:2020-06-01 00:00:00
abstract:BACKGROUND:The primary objective of this study was to determine the long-term outcome of sphincter preservation with preoperative radiation therapy (RT) and surgical resection in the treatment of distal rectal adenocarcinoma. PATIENTS AND METHODS:Between April 1988 and December 1996, 36 (cT2, n=9; cT3, n=27) patients ...
journal_title:Clinical colorectal cancer
pub_type: 杂志文章
doi:10.3816/CCC.2006.n.012
更新日期:2006-03-01 00:00:00
abstract:BACKGROUND:New treatment modalities and a growing understanding of the complex genetic tumor landscape have improved the outcome of colorectal cancer (CRC) patients. Nonetheless, more individualized treatment regimens, taking individual tumor characteristics into account, have been recently postulated and prognostic bi...
journal_title:Clinical colorectal cancer
pub_type: 杂志文章
doi:10.1016/j.clcc.2018.02.008
更新日期:2018-06-01 00:00:00