P-0254 - Tolerance of raltitrexed when replacing a fluoropyrimidine in colorectal cancer

Date 28 June 2014
Event World GI 2014
Session Poster Session
Topics Anti-Cancer Agents & Biologic Therapy
Colon Cancer
Rectal Cancer
Presenter Esther Una Cidon
Citation Annals of Oncology (2014) 25 (suppl_2): ii14-ii104. 10.1093/annonc/mdu165
Authors E. Una Cidon1, P. Alonso2
  • 1Oncology Department, Royal Bournemouth Hospital, NHS Foundation Trust, Bournemouth/UK
  • 2Clinical University Hospital, Valladolid/ES



Fluoropyrimidines are the backbone of the majority of approved chemotherapy regimens for colorectal cancer (CRC). However, they are not free of toxicities which sometimes may preclude their administration or continuation. Raltitrexed is indicated for palliative treatment of advanced CRC where 5-fluorouracil (5-FU) is inappropriate or not tolerated, thus in those cases with intolerance to fluoropyrimidines we replace them by this drug.


We carried out a retrospective study to identify the reasons for using raltitrexed in our CRC population and the most frequent toxicities experienced. Clinical notes from patients diagnosed with CRC were identified and those who received raltitrexed in the last year were included.


We evaluated 156 patients with CRC, 36 eligible (21 men, 15 women). 28 were receiving adjuvant treatment while 8 were metastatic. 30/36 were on capecitabine, 6 on 5-FU. The reasons to change for raltitrexed were: permanent palpitations (31%), ischaemic cardiopathy (39%), uncontrollable diarrhoea and stomatitis (16%), palmo-plantar dysesthesia (14%). All the patients were able to finish the therapy without any delays. In 18/28 the raltitrexed was combined with oxaliplatin as adjuvant treatment and in 5/8 in metastatic setting. The most frequent toxicities seen with raltitrexed were diarrhoea, tiredness, stomatitis and anorexia, but all of them grade 1-2.


Raltitrexed has got a favourable safety profile compared to fluoropyrimidines and it is well tolerated when replacing those in CRC patients..