Scientific article
OA Policy
English

Drug-Drug Interactions of Irinotecan, 5-Fluorouracil, Folinic Acid and Oxaliplatin and Its Activity in Colorectal Carcinoma Treatment

Published inMolecules, vol. 25, 2614
Publication date2020
Abstract

The combination of folinic acid, 5-fluorouracil, oxaliplatin and/or irinotecan (FOLFOXIRI) is the standard of care for metastatic colorectal cancer (CRC). This strategy inhibits tumor growth but provokes drug resistance and serious side effects. We aimed to improve FOLFOXIRI by optimization of the dosing and the sequence of drug administration. We employed an orthogonal array composite design and linear regression analysis to obtain cell line-specific drug combinations for four CRC cell lines (DLD1, SW620, HCT116, LS174T). Our results confirmed the synergy between folinic acid and 5-fluorouracil and additivity, or even antagonism, between the other drugs of the combination. The drug combination administered at clinical doses resulted in significantly higher antagonistic interactions compared to the low-dose optimized drug combination (ODC). We found that the concomitant administration of the optimized drug combination (ODC) was comparatively active to sequential administration. However, the administration of oxaliplatin or the active metabolite of irinotecan seemed to sensitize the cells to the combination of folinic acid and 5-fluorouracil. ODCs were similarly active in non-cancerous cells as compared to the clinically used doses, indicating a lack of reduction of side effects. Interestingly, ODCs were inactive in CRC cells chronically pretreated with FOLFOXIRI, suggesting the occurrence of resistance. We were unable to improve FOLFOXIRI in terms of efficacy or specificity. Improvement of CRC treatment should come from the optimization of targeted drugs and immunotherapy strategies.

Keywords
  • Colorectal carcinoma (CRC)
  • Drug-drug interaction
  • Optimized drug combination
  • Treatment schedule
  • Synergy
Citation (ISO format)
ZOETEMELK, Marloes et al. Drug-Drug Interactions of Irinotecan, 5-Fluorouracil, Folinic Acid and Oxaliplatin and Its Activity in Colorectal Carcinoma Treatment. In: Molecules, 2020, vol. 25, p. 2614. doi: 10.3390/molecules25112614
Main files (1)
Article (Published version)
Identifiers
Journal ISSN1420-3049
385views
347downloads

Technical informations

Creation04/06/2020 17:36:00
First validation04/06/2020 17:36:00
Update15/03/2023 22:02:08
Status update15/03/2023 22:02:08
Last indexation31/10/2024 18:47:29
All rights reserved by Archive ouverte UNIGE and the University of GenevaunigeBlack