Role of Palifermin in Fluorouracil-Based Therapy for Metastatic Colorectal Cancer

Abstract

We would like to address questions raised in Dr Haines’ Letter to the Editor published July 1, 2007,1 regarding the study, “Palifermin reduces the incidence of mucositis in patients with metastatic colorectal cancer treated with fluorouracil-based chemotherapy.”2

With respect to the choice of treatment regimen used, the particular fluorouracil / leucovorin (FU/ LV, Mayo) regimen used in this study was widely used both in the United States and Australia at the time the study was designed and conducted. The study commenced in the mid 1990s, with the final patient enrolled onto the treatment phase of the trial in May 2000. Dr Haines cites a study by Wang et al,3 however this was not published until after our study had completed accrual. On the other hand, a much larger study involving 372 patients published in 1994 in this journal,4 suggested that the Mayo schedule as used in this study2 was preferable to the original, weekly Roswell Park regimen of FU and folinic acid, on the basis of similar effectiveness with reduced toxicity.