Dietary methionine restriction with FOLFOX regimen as first line therapy of metastatic colorectal cancer: a feasibility study

Oncology. 2010;78(3-4):205-9. doi: 10.1159/000313700. Epub 2010 Apr 26.

Abstract

The methionine (MET) dependency of tumor cells opens interesting perspectives for targeting tumor cells and potentiating chemotherapy treatment, like 5-fluorouracil (5-FU) and platinum compound. Since MET deprivation can individually potentiate the different chemotherapeutic agents used in the 48-hour combined regimen of 5-FU, leucovorin and oxaliplatin (FOLFOX) regimen, we initiated a feasibility study associating dietary MET restriction with the FOLFOX regimen in patients with metastatic colorectal cancer.

Objectives: (i) To evaluate the depletion in the plasma MET concentration, and (ii) to assess the feasibility of this combination.

Methods: Eleven patients were enrolled in this study. They received a median number of 3 two-week cycles of a MET-free diet (3 consecutive days) and FOLFOX6 regimen.

Results: The plasma MET concentration was reduced by dietary MET restriction, with a depletion of 58% on the 1st day of MET-free diet. Indeed, we demonstrated the feasibility and good tolerance (nutritional status and toxicity) of the association of a MET-free diet with the FOLFOX regimen. Despite good compliance to the diet, this study revealed the difficulty of administering this combination during further months. Among the 4 patients evaluable for response, 3 experienced a partial response and 1 patient a disease stabilization.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Colorectal Neoplasms / diet therapy*
  • Colorectal Neoplasms / drug therapy*
  • Colorectal Neoplasms / pathology
  • Diet*
  • Disease Progression
  • Feasibility Studies
  • Female
  • Fluorouracil / therapeutic use
  • Humans
  • Leucovorin / therapeutic use
  • Male
  • Methionine / chemistry
  • Methionine / metabolism*
  • Middle Aged
  • Models, Statistical
  • Monitoring, Physiologic
  • Neoplasm Metastasis
  • Organoplatinum Compounds / therapeutic use
  • Treatment Outcome

Substances

  • Organoplatinum Compounds
  • Methionine
  • Leucovorin
  • Fluorouracil

Supplementary concepts

  • Folfox protocol