5-Fluorouracil (5-FU) is a principal chemotherapeutic agent for treatment of a variety of
malignant diseases. The standard method for dosing of 5-FU has been based on body surface area.
Significant variation of plasma levels of 5-FU among individuals has been shown to influence the
clinical outcomes. Accumulating data suggest that area under the concentration versus time curve
(AUC)-based dosing of 5-FU improves the clinical efficacy and safety profile. In this article, we reviewed
the pharmacokinetics (PK) of 5-FU and discussed the studies of PK-guided dose adjustment
of 5-FU in colorectal cancer. In recent studies, the value of PK monitoring and modifying of 5-FU
plasma level based on AUC has been investigated. As demonstrated by these data, AUC-based dosing
is associated with improved treatment responses and reduced toxicity. Commercially available
immunoassay is available to accomplish PK-based dosing of 5-FU, and that is increasingly utilized
in routine clinical practice. In conclusion, monitoring of plasma levels of 5-FU is a promising
method to improve the outcome of patients with colorectal cancer in terms of clinical efficacy and
toxicity. Large randomized trials are warranted to further verify this hypothesis and generalize the
use of PK-guided dosing of 5-FU for precision cancer treatment.
Keywords: AUC, colorectal carcinoma, 5-fluorouracil, pharmacokinetics, personalized treatment.
Rights & PermissionsPrintExport