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
Dartmouth Cancer Center combines advanced cancer research at Dartmouth and the Geisel School of Medicine, with award-winning, personalized, and compassionate patient-centered cancer care and clinical trials based at the Norris Cotton Cancer Care Pavilion at Dartmouth Health's Dartmouth Hitchcock Medical Center. With 14 locations around New Hampshire and Vermont, Dartmouth Cancer Center is one of only 57 National Cancer Institute-designated Comprehensive Cancer Centers. Each year the Dartmouth Cancer Center schedules 74,000 appointments seeing more than 4,500 newly diagnosed patients, and currently offers patients more than 240 active clinical trials. Celebrating its 50th anniversary in 2022, Dartmouth Cancer Center remains committed to excellence, outreach and education. We strive to prevent and cure cancer, enhance survivorship and to promote cancer health equity through pioneering interdisciplinary research and collaborations. Learn more at the Dartmouth Cancer Center website.
About Dartmouth Health
Dartmouth Health, New Hampshire’s only academic health system and the state’s largest private employer, serves patients across northern New England. Dartmouth Health provides access to more than 2,000 providers in almost every area of medicine, delivering care at its flagship hospital, Dartmouth Hitchcock Medical Center (DHMC) in Lebanon, NH, as well as across its wide network of hospitals, clinics and care facilities. DHMC is consistently named the #1 hospital in New Hampshire by U.S. News & World Report, and is recognized for high performance in numerous clinical specialties and procedures. Dartmouth Health includes Dartmouth Cancer Center, one of only 57 National Cancer Institute-designated Comprehensive Cancer Centers in the nation, and the only such center in northern New England; Dartmouth Health Children’s, which includes the state’s only children’s hospital and multiple locations around the region; member hospitals in Lebanon, Keene, Claremont and New London, NH, and Windsor and Bennington, VT; Dartmouth Health Home Care; and more than 24 clinics that provide ambulatory and specialty services across New Hampshire and Vermont. Through its historical partnership with Dartmouth and the Geisel School of Medicine, Dartmouth Health trains nearly 400 medical residents and fellows annually, and performs cutting-edge research and clinical trials recognized across the globe with Geisel and the White River Junction VA Medical Center in White River Junction, VT. Dartmouth Health and its more than 13,000 employees are deeply committed to serving the healthcare needs of everyone in our communities, and to providing each of our patients with exceptional, personal care.