We hope that this approach can lead to better treatment outcomes and improved survival for patients with GI cancers.
Gabriel A. Brooks, MD, MPHChemotherapy is a common treatment for many advanced gastrointestinal (GI) cancers. But standard dosing methods leave some patients receiving a lower dose of medication than what they may actually need.
“The current approach to chemotherapy dosing—calculated using a patient’s height and weight—does not account for individual differences between people that can affect how chemotherapy is metabolized in the body,” said Gabriel A. Brooks, MD, MPH, a medical oncologist with the gastrointestinal oncology program at Dartmouth Health’s Dartmouth Cancer Center (DCC). “As a result, up to 50% of patients may be receiving a dose that is too low, based on measured drug levels in the blood.”
Rethinking how chemotherapy is dosed
To address this issue, Brooks is leading a clinical trial at DCC that is testing a more personalized approach to chemotherapy dosing. The study focuses on a widely prescribed chemotherapy backbone called FOLFOX (5-fluorouracil and oxaliplatin).
“This trial is for patients who will receive the FOLFOX chemotherapy regimen, which includes the drug 5-fluorouracil (5-FU), as the primary treatment for advanced cancers of the esophagus, stomach, small intestine, colon, and rectum,” said Brooks.
Patients begin with a standard dose of 5-FU. For those who tolerate treatment well, without developing unnecessary side effects, the dose is carefully increased.
“The ultimate goal is to establish a new approach to finding an individualized chemotherapy dose for 5-FU that reduces the risk of underdosing and helps ensure each patient receives the dose that is right for them,” said Brooks.
A DCC-led effort
Currently, this research is exclusive to DCC. It is available to patients at the Lebanon, NH, and St. Johnsbury, VT, locations. Enrollment is expected to be completed within six months, and study results are anticipated in 2027.
Clinical trials such as the FOX regimen trial reflect DCC’s commitment to precision medicine—adapting treatment to the individual, not just the diagnosis.
“We hope that this approach can lead to better treatment outcomes and improved survival for patients with GI cancers,” said Brooks.
Patients interested in learning more about this clinical trial are encouraged to speak with their oncology care team.
About Dartmouth Cancer Center
Since 1972, Dartmouth Cancer Center (DCC) has combined groundbreaking and advanced cancer research at Dartmouth and the Geisel School of Medicine with award-winning, personalized, compassionate, patient-centered cancer care and clinical trials. At its flagship location at Dartmouth Health’s Dartmouth Hitchcock Medical Center, with 14 locations across New Hampshire and Vermont, DCC is one of fewer than 60 National Cancer Institute-designated Comprehensive Cancer Centers nationally. Each year, DCC manages 74,000 appointments, treats more than 4,500 newly diagnosed patients, and currently offers more than 240 active clinical trials. DCC remains committed to excellence, outreach and education. DCC strives to create new knowledge and impact, accelerate integrated and collaborative research to prevent and cure cancer, enhance survivorship and promote cancer-related health equity. Learn more at cancer.dartmouth.edu.
About Dartmouth Health
Dartmouth Health, New Hampshire’s only academic health system and largest private employer, serves patients across New England. Dartmouth Health provides access to more than 2,300 providers in nearly every area of medicine, delivering care at its flagship hospital, Dartmouth Hitchcock Medical Center (DHMC) in Lebanon, NH. Its network of hospitals, outpatient centers, clinics and home care facilities, spans a broad geographical area. Year after year, DHMC is named the #1 hospital in New Hampshire by U.S. News & World Report, and is consistently recognized for high performance in numerous clinical specialties and procedures. Dartmouth Health includes Dartmouth Cancer Center, northern New England’s only National Cancer Institute-designated Comprehensive Cancer Centers and one of less than than 60 total nationally; Dartmouth Health Children’s, which includes the state’s only children’s hospital (Children’s Hospital at DHMC/CHaD) and more than 20 locations around the region; eight member hospitals in Lebanon, Keene, Claremont, Hampstead, and New London, NH, and Windsor and Bennington, VT; Dartmouth Health Home Care; Dartmouth Health Connected Care Center for Telehealth, serving patients as far away as Texas; and more than 30 primary and multi-specialty clinics across New Hampshire and Vermont. Through its partnership with Dartmouth College, Dartmouth’s Geisel School of Medicine and the White River Junction VA Medical Center, Dartmouth Health trains nearly 400 medical residents and fellows annually and performs cutting-edge research and clinical trials with international impact. Dartmouth Health and its more than 16,000 employees are committed to serving the healthcare needs of everyone in the communities it serves and to providing every patient with exceptional, state-of-the-art, personalized care. Learn more at dartmouth-health.org.