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Leucovorin and 5-Fluorouracil as a Treatment for Disseminated Cancer of the Pancreas and Unknown Primary Tumors¹

Departments of Medicine [H. W. B.] and Neoplastic Diseases [H. W. B., J. C., A. M.], Mount Sinai School of Medicine, New York, New York 10029, and Department of Medicine, St. Luke's Medical Center, Milwaukee, Wisconsin 53215 [R. H.]

Chemotherapy with leucovorin (100 to 200 mg) and 5-fluorouracil (30 mg/kg) every 2 wk produced four (three complete) objective responses among a group of eight patients with early metastatic pancreatic primary and unknown cancers. Complete remissions were associated with exceptionally long durations of survival, one in a patient failing prior combination chemotherapy. This treatment warrants testing because of its ease, scientific rationale, and the large population of patients with early metastatic pancreatic cancer for whom there is no accepted treatment. Early metastatic disease is defined as small metastatic lesions not immediately life threatening found in a physiologically intact patient. Controlled trials, demonstrating benefit associated with other 5-fluorouracil-containing regimens for patients with nonmetastatic stages of pancreatic cancer, provide a rationale for extending testing of leucovorin and 5-fluorouracil to other early stages of pancreatic cancer.

¹ Supported in part by Cancer Center Grant P30-CA-23102 awarded by the National Cancer Institute. Initially presented at the National Meeting of the American Association for Cancer Research, 1985, and Tarpon Springs Consensus Conference on Folates and Antifolates, 1986.

² To whom requests for reprints should be addressed, at Mount Sinai School of Medicine, 1 Gustave L. Levy Place, Box 1178, New York, NY 10029.

Received 8/25/87. Revised 2/ 1/88. Revised 6/27/88. Accepted 7/ 6/88.