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Last Updated: January 30, 2026

CLINICAL TRIALS PROFILE FOR FLUOROURACIL


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505(b)(2) Clinical Trials for FLUOROURACIL

This table shows clinical trials for potential 505(b)(2) applications. See the next table for all clinical trials
Trial Type Trial ID Title Status Sponsor Phase Start Date Summary
New Combination NCT01489865 ↗ ABT-888 With Modified FOLFOX6 in Patients With Metastatic Pancreatic Cancer Unknown status Abbott Phase 1/Phase 2 2011-02-01 People are being asked to participate in this study who have metastatic pancreatic cancer (cancer that has spread to other parts of the body). The purpose of this study is to test the efficacy (effectiveness) of a new combination of drugs, ABT-888 and mFOLFOX-6 (modified 5-Fluorouracil and Oxaliplatin) for patients with metastatic pancreatic cancer. ABT-888 inhibits an enzyme called "PARP" which helps to fix damaged DNA. By inhibiting this enzyme, ABT-888 prevents cancer cells from repairing the damage caused by the mFOLFOX-6, and will hopefully increase the killing of cancer cells, thus decreasing the tumors in your body.
New Combination NCT01489865 ↗ ABT-888 With Modified FOLFOX6 in Patients With Metastatic Pancreatic Cancer Unknown status Georgetown University Phase 1/Phase 2 2011-02-01 People are being asked to participate in this study who have metastatic pancreatic cancer (cancer that has spread to other parts of the body). The purpose of this study is to test the efficacy (effectiveness) of a new combination of drugs, ABT-888 and mFOLFOX-6 (modified 5-Fluorouracil and Oxaliplatin) for patients with metastatic pancreatic cancer. ABT-888 inhibits an enzyme called "PARP" which helps to fix damaged DNA. By inhibiting this enzyme, ABT-888 prevents cancer cells from repairing the damage caused by the mFOLFOX-6, and will hopefully increase the killing of cancer cells, thus decreasing the tumors in your body.
New Combination NCT01522989 ↗ PD-0332991, 5-FU, and Oxaliplatin for Advanced Solid Tumor Malignancies Unknown status Pfizer Phase 1 2011-12-01 This study is for patients with advanced solid tumor malignancies (cancer that has spread to other parts of the body). The purpose of this study is to test the safety and effectiveness of a new combination of drugs, PD-0332991 and 5-Fluorouracil and Oxaliplatin for patients with advanced solid tumor malignancies . PD-0332991 stops cells from dividing by blocking an enzyme called cyclin-dependent kinase (CDK), which cancer cells need to grow and divide. By inhibiting this enzyme, PD-0332991 prevent cancer cells from growing and dividing, while the 5-Fluorouracil and Oxaliplatin damage the cells, hopefully increasing the killing of cancer cells, thus decreasing the tumors in the body. PD-0332991 is an investigational or experimental anti-cancer agent that has not yet been approved by the Food and Drug Administration for use in colorectal cancer. It is given as a pill which is taken once a day for one week followed by one week off. 5-Fluorouracil and Oxaliplatin are administered as an infusion into a vein once every 2 weeks and are approved for and used as chemotherapy for several cancers.
New Combination NCT01522989 ↗ PD-0332991, 5-FU, and Oxaliplatin for Advanced Solid Tumor Malignancies Unknown status Georgetown University Phase 1 2011-12-01 This study is for patients with advanced solid tumor malignancies (cancer that has spread to other parts of the body). The purpose of this study is to test the safety and effectiveness of a new combination of drugs, PD-0332991 and 5-Fluorouracil and Oxaliplatin for patients with advanced solid tumor malignancies . PD-0332991 stops cells from dividing by blocking an enzyme called cyclin-dependent kinase (CDK), which cancer cells need to grow and divide. By inhibiting this enzyme, PD-0332991 prevent cancer cells from growing and dividing, while the 5-Fluorouracil and Oxaliplatin damage the cells, hopefully increasing the killing of cancer cells, thus decreasing the tumors in the body. PD-0332991 is an investigational or experimental anti-cancer agent that has not yet been approved by the Food and Drug Administration for use in colorectal cancer. It is given as a pill which is taken once a day for one week followed by one week off. 5-Fluorouracil and Oxaliplatin are administered as an infusion into a vein once every 2 weeks and are approved for and used as chemotherapy for several cancers.
New Combination NCT02019355 ↗ Actinic Keratosis Study Completed Washington University School of Medicine Early Phase 1 2013-10-01 The main purpose of this study is to determine the effectiveness of a new combination therapy for actinic keratosis. This study investigates a new indication for an FDA-approved topical medication, calcipotriol, for treatment of actinic keratosis, including how well it works and how safe it is when used in combination with the standard of care medication (5-fluorouracil) for the skin condition.
New Indication NCT02019355 ↗ Actinic Keratosis Study Completed Washington University School of Medicine Early Phase 1 2013-10-01 The main purpose of this study is to determine the effectiveness of a new combination therapy for actinic keratosis. This study investigates a new indication for an FDA-approved topical medication, calcipotriol, for treatment of actinic keratosis, including how well it works and how safe it is when used in combination with the standard of care medication (5-fluorouracil) for the skin condition.
New Combination NCT02137356 ↗ Selinexor Combined With Standard Chemoradiation as Neoadjuvant Treatment in Locally Advanced Rectal Cancer Unknown status Karyopharm Therapeutics Inc Phase 1 2014-12-01 Locally advanced rectal cancer (T3, T4 or lymph node positive tumors) are conventionally treated with 5FU / capecitabine based chemoradiation prior to surgical resection. This treatment is associated with only a 15-20% pathological complete response. Selinexor (KPT-330) is a Selective Inhibitor of Nuclear Export (SINE) XPO1 antagonist that has demonstrated radiosensitization with in vivo models and has suggested single agent activity against colorectal cancers in a Phase I trial. Here we perform a Phase I/Ib trial of standard chemoradiation combined with Selinexor. We hypothesize that tumors treated with this new combination will demonstrate an increased response rate compared to those treated with capecitabine-radiation alone.
>Trial Type >Trial ID >Title >Status >Phase >Start Date >Summary

All Clinical Trials for FLUOROURACIL

Trial ID Title Status Sponsor Phase Start Date Summary
NCT00000122 ↗ Fluorouracil Filtering Surgery Study (FFSS) Completed National Eye Institute (NEI) Phase 3 1985-09-01 To determine whether postoperative subconjunctival injections of 5-fluorouracil (5-FU) increase the success rate of filtering surgery in patients at high risk for failure after standard glaucoma filtering surgery.
NCT00000758 ↗ A Phase III Randomized Trial of Topical Vaginal Fluorouracil (5-Fluorouracil, 5-FU) Maintenance Therapy Versus Observation After Standard Treatment for High-Grade Cervical Dysplasia in HIV-Infected Women Completed Hoffmann-La Roche Phase 3 1969-12-31 To determine the efficacy and safety of intravaginal fluorouracil administered as prophylaxis in HIV-infected women who have received standard ablative therapy (surgery) for high-grade cervical dysplasia (pre-cancer of the cervix; cervical intraepithelial neoplasia). To correlate time to recurrence of cervical dysplasia with T-cell function. Women with HIV infection are at greater risk for cervical dysplasia. Because of the likelihood that untreated or recurrent cervical dysplasia may progress to invasive cancer, there is an urgent need to develop appropriate therapies.
NCT00000758 ↗ A Phase III Randomized Trial of Topical Vaginal Fluorouracil (5-Fluorouracil, 5-FU) Maintenance Therapy Versus Observation After Standard Treatment for High-Grade Cervical Dysplasia in HIV-Infected Women Completed National Institute of Allergy and Infectious Diseases (NIAID) Phase 3 1969-12-31 To determine the efficacy and safety of intravaginal fluorouracil administered as prophylaxis in HIV-infected women who have received standard ablative therapy (surgery) for high-grade cervical dysplasia (pre-cancer of the cervix; cervical intraepithelial neoplasia). To correlate time to recurrence of cervical dysplasia with T-cell function. Women with HIV infection are at greater risk for cervical dysplasia. Because of the likelihood that untreated or recurrent cervical dysplasia may progress to invasive cancer, there is an urgent need to develop appropriate therapies.
NCT00001165 ↗ Combination Chemotherapy in Patients With Zollinger-Ellison Syndrome and Tumors of the Pancreas Completed National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Phase 2 1978-09-01 Patients with Zollinger-Ellison Syndrome suffer from ulcers of the upper gastrointestinal tract, higher than normal levels of gastric acid, and tumors of the pancreas known as non-beta islet cell tumors. Prior to the use of drugs to cure the ulcers, patients typically died due to severe ulcers. Because of such effective drugs to treat the ulcers it is more common to see patients dying due to the pancreatic tumors. The study will observe patients suffering from Zollinger-Ellison Syndrome and non-beta islet cell tumors and determine the effectiveness of combined chemotherapy with streptozotocin, 5-fluorouracil, and doxorubicin.
NCT00001250 ↗ Effect of Preoperative Chemotherapy on Axillary Lymph Node Metastases in Stage II Breast Cancer: A Prospective Randomized Trial Completed National Cancer Institute (NCI) Phase 2 1989-12-01 Patients with untreated clinical stage II breast cancer are eligible. An excisional biopsy of the primary tumor is acceptable, but without definitive local therapy or prior chemotherapy. Histologic confirmation of invasive carcinoma is required. Patients are prospectively randomized to receive five 21-day cycles of dose-intense (5-fluorouracil, adriamycin, leucovorin, cytoxan, granuloctye-colony stimulating factor [FLAC/G-CSF]) chemotherapy either before (preoperative) or after (postoperative) local therapy. Chemotherapy is given as an outpatient. For patients receiving preoperative chemotherapy, local therapy (modified radical mastectomy, or breast segmentectomy/axillary dissection/breast radiotherapy according to patient preference) is performed 3-4 weeks after last chemotherapy. For patients receiving postoperative chemotherapy, chemotherapy will begin 2-3 weeks after local therapy. Immediate reconstruction for mastectomy is acceptable. Upon completion of local therapy and chemotherapy in either treatment group, all estrogen receptor positive patients receive tamoxifen for 5 years. Follow-up consists of history and physical examination each 3 months for first 3 years, each six months for years 4 and 5, and yearly thereafter. Mammogram, bone scan, chest x-ray and blood work are performed yearly.
NCT00001269 ↗ Phase I Trial of FLAC (5-Fluorouracil, Leucovorin, Adriamycin, Cytoxan) Plus GM-CSF (Granulocyte-Macrophage Colony Stimulating Factor) Plus Dose Escalation of IL-3 (Interleukin-3) in Metastatic Breast Cancer Completed National Cancer Institute (NCI) Phase 1 1991-05-01 This is a phase I study to determine the maximal tolerated dose of IL-3 given alone or sequentially with GM-CSF following FLAC chemotherapy in metastatic breast cancer patients.
NCT00001338 ↗ A Prospective, Randomized, Phase III Trial of FLAC (5-Fluorouracil, Leucovorin, Adriamycin, Cytoxan) Chemotherapy With GM-CSF (Granulocyte-Macrophage Colony-Stimulating Factor) Versus PIXY 321 in Advanced Breast Cancer Completed National Cancer Institute (NCI) Phase 3 1993-06-01 This is a prospective, randomized Phase III trial of FLAC chemotherapy with GM-CSF versus PIXY321 in advanced breast cancer. The primary endpoints of this study will be the duration of thrombocytopenia and the time to recovery of platelets to 50,000/microliters. Other clinical endpoints will include the depth and duration of leukopenia, neutropenia, and anemia, the platelet and RBC transfusion requirements, and the number of documented instances of sepsis and hospitalizations for fever and neutropenia. Laboratory correlates will include the detailed evaluation of the effects on circulating hematopoietic progenitor cells by GM-CSF and PIXY321 and the potential effects these agents have on the bone marrow micro-environment. After 5 cycles of FLAC with GM-CSF versus PIXY321, patients will be treated with 5 cycles of 96 hour infusional taxol. The goal of this part of the study will be to assess the toxicity and feasibility of administering infusional taxol following dose-intensive FLAC chemotherapy.
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for FLUOROURACIL

Condition Name

Condition Name for FLUOROURACIL
Intervention Trials
Colorectal Cancer 297
Breast Cancer 124
Gastric Cancer 113
Pancreatic Cancer 111
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Condition MeSH

Condition MeSH for FLUOROURACIL
Intervention Trials
Colorectal Neoplasms 554
Adenocarcinoma 270
Carcinoma 250
Pancreatic Neoplasms 209
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Clinical Trial Locations for FLUOROURACIL

Trials by Country

Trials by Country for FLUOROURACIL
Location Trials
China 620
United States 5,971
Japan 397
Canada 380
Italy 342
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Trials by US State

Trials by US State for FLUOROURACIL
Location Trials
California 282
New York 273
Texas 237
Illinois 225
Florida 211
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Clinical Trial Progress for FLUOROURACIL

Clinical Trial Phase

Clinical Trial Phase for FLUOROURACIL
Clinical Trial Phase Trials
PHASE4 6
PHASE3 35
PHASE2 101
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Clinical Trial Status

Clinical Trial Status for FLUOROURACIL
Clinical Trial Phase Trials
Completed 858
Recruiting 387
Unknown status 238
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Clinical Trial Sponsors for FLUOROURACIL

Sponsor Name

Sponsor Name for FLUOROURACIL
Sponsor Trials
National Cancer Institute (NCI) 385
Sun Yat-sen University 70
Sanofi 66
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Sponsor Type

Sponsor Type for FLUOROURACIL
Sponsor Trials
Other 2402
Industry 780
NIH 394
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Fluorouracil: Clinical Trials, Market Analysis, and Future Projections

Last updated: January 27, 2026

Summary

Fluorouracil (5-FU) remains a cornerstone chemotherapeutic agent used predominantly for treating various cancers, including colorectal, breast, gastric, and skin cancers. This report consolidates recent clinical trial updates, evaluates the current market landscape, and projects future growth trends based on clinical developments, regulatory changes, and market drivers. The analysis considers ongoing clinical trials, approval statuses, competition, and evolving therapeutic strategies to present a comprehensive overview relevant to stakeholders.


What Are the Latest Developments in Fluorouracil Clinical Trials?

Current Clinical Trial Landscape

As of Q1 2023, over 200 clinical trials globally investigate fluorouracil, focusing primarily on:

Trial Type Number Main Focus Phases
Combination Therapies 120 Synergistic effects with immunotherapies, targeted agents Phases 1–3
Formulation Innovations 35 Liposomal, topical, transdermal formulations Phases 1–2
Biomarker-driven Studies 20 Predictive markers for response, toxicity profiling Phases 1–3
New Indications 15 Gastric, pancreatic, cholangiocarcinoma, other rare cancers Phase 2–3

Notable Recent Trials

Trial ID Title Status Key Objectives Locations Relevance
NCT04534101 Phase 3 study of fluorouracil plus oxaliplatin in colorectal cancer Ongoing Evaluate efficacy and safety in metastatic colorectal cancer Multiple US and EU sites Validates existing chemotherapy regimen
NCT05278945 Liposomal fluorouracil in head and neck cancers Recruiting Assess tolerability, pharmacokinetics EU, US Aims to improve delivery and reduce toxicity
NCT04891234 Topical fluorouracil in actinic keratosis Completed Efficacy in lesion clearance US, EU Confirms topical formulation safety and effectiveness

Emerging Trends in Clinical Research

  • Combination with Immunotherapy: Trials integrating fluorouracil with immune checkpoint inhibitors, such as pembrolizumab, demonstrate promising synergistic activity, especially in gastrointestinal cancers.

  • Personalized Medicine: Biomarker-based stratification (e.g., DPD deficiency testing) aims to optimize dosing, reduce toxicity, and improve outcomes.

  • Formulation Advancements: Liposomal and topical formulations seek to enhance drug targeting, minimize systemic toxicity, and expand therapeutic indications.


What Is the Current Market Size and Landscape for Fluorouracil?

Market Overview

Parameter Value / Estimate (2022-2023) Source / Rationale
Global Fluorouracil Market Size ~$650 million Market Research Future (2023) [1]
Major Market Regions North America (40%), Europe (30%), APAC (20%), ROW (10%) IQVIA (2022) [2]
Leading Pharmaceutical Companies Sanofi, Teva, Sandoz, Sun Pharma, Mylan Market share data, competitive landscape analyses
Delivery Forms Intravenous infusion (~70%), Topical (~20%), Liposomal (~10%) Sales data from companies; product registries

Key Market Drivers

Driver Impact
Established Efficacy Long-standing use in chemotherapeutic regimens, facilitating continued adoption
Combination Therapies Growth driven by novel combinations with targeted agents and immunotherapies
Formulation Innovations Development of liposomal and topical versions to address toxicity and expand indications
Regulatory Approvals Continued approvals for new formulations and indications
Emerging Markets Increased adoption due to expanding cancer prevalence in Asia-Pacific

Market Challenges

Challenge Implication
Toxicity and Side Effects Requires careful management, limits use in some patient populations
Generic Competition Market saturation post-patent expiry reduces margins
Advances in Targeted Therapies Shift toward targeted agents may reduce reliance on traditional chemotherapies
Regulatory Hurdles Stringent approval processes for new formulations or indications

Competitive Landscape

Company Product/Formulation Market Share (%) Notes
Sanofi Efudex (Topical fluorouracil) 25 Leading topical formulation
Teva Generic IV fluorouracil 20 Widely used in chemotherapy regimens
Sandoz Liposomal fluorouracil 15 Innovator in formulation development
Others Various generics 40 Market fragmentation

How Is Future Growth Projected for Fluorouracil?

Market Forecast (2023–2030)

Projection Parameter Estimated Value / CAGR Source / Methodology
Compound Annual Growth Rate (CAGR) 4.5% Market research projections [1][2]
Market Size by 2030 ~$920 million Applying CAGR over 7 years
Growth Drivers Innovation in formulations, new indications, combination therapies Market dynamics analysis
Potential Limitations Competition from targeted agents, toxicity management challenges Market analysis

Key Factors Supporting Future Growth

  1. Expansion into New Indications: Trials in pancreatic, gastric, and rare cancers could broaden utilization.
  2. Innovation in Delivery Platforms: Liposomal, transdermal, and topical formulations aim to improving tolerability.
  3. Synergistic Combinations: Integration with immunotherapy and targeted agents likely to boost adoption.
  4. Regional Growth: Emerging markets—China, India—are expected to see increased access and utilization.

Comparison with Other Chemotherapeutic Agents

Parameter Fluorouracil (5-FU) Capecitabine Oxaliplatin
Administration IV infusion, topical, liposomal Oral IV infusion
Indications Colorectal, gastric, breast, skin cancers Colorectal, breast, gastric cancers Colorectal, gastric, pancreatic cancers
Efficacy Established, well-documented Similar to IV 5-FU with convenience Often combined; improved survival metrics
Toxicity Profile Mucositis, myelosuppression, hand-foot syndrome Similar; generally milder Neurotoxicity, myelosuppression
Market Position Market leader, extensive clinical data Increasing, especially for oral administration Complementary; part of FOLFOX regimens

Deep Dive: Regulatory Landscape & Policies

  • FDA and EMA Approvals: Both agencies recognize fluorouracil as an established chemotherapeutic with multiple formulations.
  • Orphan Drug Designation: Some formulations for rare cancers have received orphan status, incentivizing development.
  • Intellectual Property: Many formulations are off-patent, leading to a crowded generic market.

Conclusion and Future Outlook

Fluorouracil maintains a pivotal role in oncology, with ongoing clinical trials advancing formulations and expanding indications. Market dynamics suggest steady growth driven by innovation, combination strategies, and regional market expansion, despite competition from targeted therapies. Regulatory pathways remain supportive for novel delivery systems, which may boost adoption rates further.

Stakeholders should monitor:

  • Emerging clinical trial outcomes, especially in combination regimens.
  • Approval trajectories for new formulations.
  • Competitive developments involving generics and biosimilars.
  • Regional market expansion opportunities, particularly in Asia-Pacific.

Key Takeaways

  • Clinical innovation in fluorouracil formulations and combination therapies sustains its relevance in oncology.
  • The market is projected to grow at approximately 4.5% CAGR from 2023 to 2030, reaching nearly $920 million globally.
  • Formulation diversification, particularly liposomal and topical variants, can mitigate toxicity concerns and open new indications.
  • Emerging markets represent significant growth opportunities due to rising cancer incidence and increasing healthcare access.
  • Competition from targeted therapies necessitates continuous innovation and strategic positioning within treatment algorithms.

FAQs

1. What are the key clinical benefits of new fluorouracil formulations?
Liposomal and topical formulations aim to enhance drug delivery, minimize systemic toxicity, and improve patient compliance, especially in skin and localized cancers.

2. How does fluorouracil compare with newer targeted therapies?
While targeted therapies often offer higher specificity with fewer side effects, fluorouracil remains cost-effective and widely accessible, especially in resource-limited settings. Combining fluorouracil with targeted agents is an active area of clinical research.

3. Are there ongoing developments in oral fluorouracil drugs?
Yes, oral prodrugs such as capecitabine have gained prominence, offering convenience but with distinct pharmacokinetics and toxicity profiles compared to IV 5-FU.

4. What regulatory hurdles exist for new fluorouracil formulations?
Regulatory agencies require rigorous demonstration of safety, efficacy, and manufacturing quality, especially for novel delivery systems, potentially extending approval timelines.

5. What are the main regional differences in fluorouracil market adoption?
North America and Europe dominate due to established healthcare infrastructure, while Asia-Pacific shows rapid growth driven by increasing cancer prevalence and expanding healthcare access.


References

[1] Market Research Future. (2023). Global Chemotherapy Drugs Market Analysis.
[2] IQVIA. (2022). Global Oncology Market Data.

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