Pharmacokinetic (PK) guided optimization of 5-fluorouracil (5-FU) dosing in the treatment of patients with colorectal cancer (CRC).

e14561 Background: 5-FU has been the backbone of systemic combination chemotherapy for treatment of CRC in the adjuvant and metastatic disease settings. The dosing of 5-FU has traditionally been based on body surface area (BSA). Growing evidence suggests that BSA-based 5-FU dosing has several limitations, and that PK-guided dosing of 5-FU improves clinical efficacy with reduced toxicity. We conducted this Quality Improvement project to evaluate the clinical feasibility of PK-guided 5-FU dose adjustment and its impact on clinical outcome. Methods: CRC patients treated with combination chemotherapy regimens containing infusional 5-FU at the UPMC Cancer Center who underwent PK-guided optimization of 5-FU dosing using an immunoassay (OnDose or MyCare) were included in the analysis. Results: A total of 21 patients (8 males, 13 females) meeting the entry criteria have been identified to date. The median age was 61 years (range, 41-82). Six patients had stage III disease, and the remaining 15 patients had stage ...