• Lorenzo Fornaro, G Masi, S Bursi, F Loupakis, E Vasile, A Antonuzzo, S Chiara, E Pfanner, A Di Paolo, G Bocci, M Del Tacca, and A Falcone.
• Department of Oncology, Azienda USL6 of Livorno, Istituto Toscano Tumori, Viale Alfieri, 36, 57124, Livorno, Italy. lorenzo.fornaro@gmail.com
• Cancer Chemother. Pharmacol. 2009 Apr 1; 63 (5): 965-9.

PurposeThe GONO-FOLFOXIRI regimen demonstrated higher activity and efficacy than FOLFIRI in metastatic colorectal cancer patients. The aim of this study was to determine the maximum tolerated dose of capecitabine, in substitution of 5-fluorouracil, combined with oxaliplatin and irinotecan and to evaluate the pharmacokinetics of the drugs.Patients And MethodsWe treated 15 patients with escalating doses of capecitabine (from day 1 to 7) and fixed doses of oxaliplatin (85 mg/m(2)) plus irinotecan (165 mg/m(2)) (both administered on day 1), repeated every 2 weeks. Pharmacokinetic analysis was performed on plasma samples collected at the first cycle of treatment.ResultsThe maximum tolerated dose of capecitabine resulted 2,000 mg/m(2)/day, with diarrhea being the only dose-limiting toxicity. Large interpatient variability in the pharmacokinetic parameters of investigated drugs was observed. Results in terms of activity are promising.ConclusionsAt the maximum tolerated dose of capecitabine of 2,000 mg/m(2)/day the combination is feasible with promising activity and deserves further investigations.

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