Evidence map›Paper›PMID 36183444›Full record

Trial reportESMO open2022

A phase I/II study of arfolitixorin and 5-fluorouracil in combination with oxaliplatin (plus or minus bevacizumab) or irinotecan in metastatic colorectal cancer.

G Carlsson, A Koumarianou, T K Guren, J Haux, P Katsaounis, N Kentepozidis, P Pfeiffer, M Brændengen, D Mavroudis, H Taflin and 3 more

Registry-linked trialOpen access · goldAbstract readClinical Trial, Phase IIClinical Trial, Phase IMulticenter Study
In one paragraph

Trial report in ESMO open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02244632 (An Open-label, Multiple-site, Phase I/II Dose Cohort Trial of [6R] 5,10-Methylene Tetrahydrofolate), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
0.2field-weighted citation impact, top 45% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02244632 phase1 / phase2completednot on this map

An Open-label, Multiple-site, Phase I/II Dose Cohort Trial of [6R] 5,10-Methylene Tetrahydrofolate (Modufolin®) in Combination With a Fixed Dose of 5-Fluorouracil (5-FU) Alone or Together With a Fixed Dose of Oxaliplatin or Irinotecan in Patients With Stage IV Colorectal Cancer

TypeinterventionalSponsorIsofol Medical ABRan2014 to 2020Enrolled105ConditionsColorectal NeoplasmArmsModufolin (arfolitixorin), Fluorouracil, Oxaliplatin, Irinotecan, Bevacizumab
3 · Its place in the literature

Who cites it

0 citing papers in PubMed, 2 citations in OpenAlex.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 9 institutions in 4 countries.

G CarlssonDepartment of Surgery, University of Gothenburg, Sahlgrenska University Hospital/Östra Institute of Clinical Sciences, Gothenburg, Sweden. Electronic address: goran.u.carlsson@vgregion.se.
A KoumarianouHematology Oncology Unit, Fourth Department of Internal Medicine, Attikon University Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece.
T K GurenDepartment of Oncology, Oslo University Hospital, Oslo, Norway.
J HauxDepartment of Surgery, Skaraborg Hospital, Skövde, Sweden.
P KatsaounisOncology Department, Metropolitan General Hospital, Athens, Greece.
N KentepozidisDepartment of Medical Oncology, 251 General Air Force Hospital, Athens, Greece.
P PfeifferExperimental Research in Medical Cancer Therapy, Odense University Hospital, Odense, Denmark.
M BrændengenDepartment of Oncology, Oslo University Hospital, Oslo, Norway.
D MavroudisDepartment of Medical Oncology, University Hospital of Heraklion, Heraklion, Crete, Greece.
H TaflinDepartment of Transplant Surgery, The Institute of Clinical Sciences, The Sahlgrenska Academy At University of Gothenburg, Gothenburg, Sweden.
L SkintemoIsofol Medical AB, Gothenburg, Sweden.
R TellIsofol Medical AB, Gothenburg, Sweden.
C PapadimitriouOncology Unit, 'Aretaieion' University Hospital, National and Kapodistrian University of Athens, Athens, Greece.
Isofol (Sweden) · SENational and Kapodistrian University of Athens · GROslo University Hospital · NOMetropolitan Hospital · GROdense University Hospital · DKSahlgrenska University Hospital · SESkaraborg Hospital · SEUniversity Hospital of Heraklion · GRUniversity of Gothenburg · SE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background5-fluorouracil (5-FU) combined with a folate remains an essential treatment component for metastatic colorectal cancer (mCRC). Leucovorin is the folate most often used, but requires intracellular conversion to a reduced folate, and has high pharmacokinetic variability and limited bioavailability in patients with low folate pathway gene expression. Arfolitixorin is an immediately active form of folate, [6R]-5,10-methylenetetrahydrofolate ([6R]-MTHF), and may improve outcomes. PATIENTS AND

methodsThis open-label, multicenter, phase I/II study in patients with mCRC (NCT02244632) assessed the tolerability and efficacy of first- or second-line arfolitixorin (30, 60, 120, or 240 mg/m

resultsIn 105 treated patients, investigators reported 583 adverse events (AEs) in 86 patients (81.9%), and 256 AEs (43.9%) were potentially related to arfolitixorin and 5-FU. Dose adjustments were required in 16 patients (15.2%). At 8 weeks, 9 out of 57 patients assessed for efficacy achieved an objective response (15.8%), and all 9 achieved a partial response. Six of these nine patients had received arfolitixorin as a first-line treatment. A further 33 patients (57.9%) achieved stable disease. Pharmacokinetics were assessed in 35 patients. The average t

conclusionsArfolitixorin is a well-tolerated moderator of 5-FU activity. It is suitable for further investigation in mCRC and has the potential to improve treatment outcomes in patients with low folate pathway gene expression. Arfolitixorin can easily be incorporated into current standard of care, requiring minimal changes to chemotherapy regimens.

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsColorectal NeoplasmsBevacizumabFluorouracilHumansIrinotecanLeucovorinOxaliplatinBevacizumabFluorouracilIrinotecanLeucovorinOxaliplatin[6R]-5,10-methylentetrahydrofolatearfolitixorinchemotherapycolorectalfluorouracilfolate

Identifiers

PMID36183444
PMCPMC9588906
OpenAlexW4297946293

What Socratic holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.