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Last Updated: December 12, 2025

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.
>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.
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for FLUOROURACIL

Condition Name

Condition Name for FLUOROURACIL
Intervention Trials
Colorectal Cancer 295
Breast Cancer 124
Gastric Cancer 113
Pancreatic Cancer 110
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Condition MeSH

Condition MeSH for FLUOROURACIL
Intervention Trials
Colorectal Neoplasms 549
Adenocarcinoma 270
Carcinoma 250
Pancreatic Neoplasms 207
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Clinical Trial Locations for FLUOROURACIL

Trials by Country

Trials by Country for FLUOROURACIL
Location Trials
China 618
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 5
PHASE3 30
PHASE2 97
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Clinical Trial Status

Clinical Trial Status for FLUOROURACIL
Clinical Trial Phase Trials
Completed 857
Recruiting 385
Unknown status 238
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Clinical Trial Sponsors for FLUOROURACIL

Sponsor Name

Sponsor Name for FLUOROURACIL
Sponsor Trials
National Cancer Institute (NCI) 383
Sun Yat-sen University 70
Sanofi 66
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Sponsor Type

Sponsor Type for FLUOROURACIL
Sponsor Trials
Other 2391
Industry 771
NIH 392
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Clinical Trials Update, Market Analysis, and Projection for Fluorouracil

Last updated: October 28, 2025

Introduction

Fluorouracil (5-FU) remains a cornerstone in oncologic therapy, primarily serving as a chemotherapeutic agent for various cancers. Its mechanism — inhibiting thymidylate synthase, disrupting DNA synthesis — underpins its longstanding clinical utility. This analysis delves into the latest clinical trial developments, current market landscape, and future projections for fluorouracil, offering insights for stakeholders aiming to navigate its evolving therapeutic and commercial environment.


Clinical Trials Update: Therapeutic Innovations and Emerging Indications

Recent years have seen notable advances in fluorouracil research, emphasizing enhanced delivery systems, combination regimens, and expanded indications. Several pivotal trials and ongoing studies reflect this dynamic landscape.

1. Innovations in Drug Delivery and Formulations

Scientific efforts focus on improving fluorouracil's pharmacokinetics and safety profiles. Liposomal and nanoparticle-based formulations aim to optimize bioavailability and reduce systemic toxicity.

  • Liposomal Fluorouracil: Phase II studies have demonstrated that liposomal encapsulation enhances tumor targeting, particularly in colorectal and head and neck cancers, potentially leading to higher local concentrations and reduced adverse effects ([2]).

  • Topical Formulations: The FDA-approved Fluorouracil Topical (carcinogenesis) is undergoing trials assessing its efficacy in basal cell carcinoma and actinic keratosis, expanding non-invasive treatment options ([3]).

2. Expanding Therapeutic Indications

Investigator-initiated and industry-sponsored trials are exploring fluorouracil's role beyond traditional domains.

  • Colorectal Cancer (CRC): Ongoing Phase III trials examine fluorouracil combined with targeted agents such as cetuximab and bevacizumab in metastatic settings, aiming to improve progression-free survival.

  • Gastrointestinal Cancers: Trials evaluate fluorouracil in combination with immunotherapies, including PD-1 inhibitors, reflecting a paradigm shift toward immunochemotherapy.

  • Brain Tumors: Preliminary studies investigate intrathecal delivery of fluorouracil for recurrent gliomas, seeking to overcome the blood-brain barrier challenge.

3. Combination Therapies and Personalized Approaches

  • Chemoradiation Synergy: Multiple trials validate fluorouracil as a key component in concomitant chemoradiation protocols for rectal and esophageal cancers.

  • Biomarker-Driven Trials: Efforts are underway to identify biomarkers predicting fluorouracil response, particularly dihydropyrimidine dehydrogenase (DPD) deficiency’s role in toxicity risk.

4. Noteworthy Ongoing Studies

Clinical Trial ID Focus Area Status Expected Completion
NCT04928405 Liposomal fluorouracil in gastric cancer Recruiting 2024 Q4
NCT04549340 Fluorouracil + PD-1 inhibitors in pancreatic cancer Active, not recruiting 2023 Q3
NCT04266029 Intrathecal fluorouracil for gliomas Recruiting 2025 Q1

Sources: ClinicalTrials.gov, 2023.


Market Analysis: Landscape and Key Drivers

1. Current Market Size

The global fluorouracil market was valued at approximately USD 250 million in 2022, driven primarily by demand in colorectal, breast, and head and neck cancers ([4]). Its essential role in chemotherapy regimens sustains steady revenue streams despite the advent of targeted and immunotherapies.

2. Segment and Regional Dynamics

  • Segmentiation: The market is segmented into injectable formulations, topical creams, and novel delivery systems. Injectable fluorouracil accounts for over 75% of sales, owing to its widespread use in systemic chemotherapy protocols.

  • Regional Insights: North America dominates the market, accounting for roughly 40%, driven by high cancer prevalence and established healthcare infrastructure. The Asia-Pacific region shows significant growth potential owing to rising cancer incidence, increasing healthcare expenditure, and expanding pharmaceutical R&D.

3. Market Drivers

  • Clinical Demands: Despite competition from targeted agents, fluorouracil’s proven efficacy keeps it integral to treatment algorithms.

  • Regulatory Approvals: The approval of new formulations (e.g., liposomal) is expanding market applications.

  • Manufacturing and Cost: As a generic drug, fluorouracil maintains a cost advantage, facilitating widespread use in low- to middle-income countries.

4. Market Challenges

  • Toxicity Profile: Dose-limiting toxicities such as myelosuppression and mucositis necessitate supportive care, sometimes limiting use.

  • Emerging Alternatives: Targeted therapies and immunotherapies are increasingly replacing fluorouracil in certain indications, threatening market share.

  • Supply Chain Disruptions: Global events, such as COVID-19, have intermittently impacted manufacturing and distribution.


Market Projections: 2023–2030

Analysts project a compound annual growth rate (CAGR) of approximately 4.2% for the fluorouracil market over the next decade, reaching approximately USD 370 million by 2030. Growth will be driven by:

  • Increasing adoption of combination regimens involving fluorouracil and novel agents.
  • Rising global cancer burdens, particularly in Asia-Pacific.
  • Development of innovative formulations reducing toxicity and expanding indications.
  • Regulatory endorsements for topical and targeted delivery systems.

However, the trajectory may be tempered by the ongoing contest from newer targeted therapies and immunotherapies, which could overshadow fluorouracil in certain niches.


Conclusion

Fluorouracil remains a pivotal chemotherapeutic agent, with ongoing clinical trials addressing its delivery, safety, and expanded applications. The market exhibits resilience, supported by its established efficacy, cost-effectiveness, and adaptability through innovative formulations. Future growth depends on successful integration with targeted approaches, personalized medicine, and ongoing research breakthroughs.


Key Takeaways

  • Clinical innovation focuses on novel delivery systems (liposomal, topical) and combination therapies, aiming to improve efficacy and reduce toxicity.
  • Regulatory and clinical trial momentum suggests continued validation of fluorouracil's role in combination regimens for various cancers.
  • Market stability is underpinned by its low cost, widespread use, and the expanding global cancer burden, especially in emerging markets.
  • Future growth prospects hinge on technological advancements, biomarker-driven personalization, and integration with immunotherapies, potentially extending fluorouracil's lifecycle.
  • Competitive landscape will need to adapt as targeted and immune therapies evolve and challenge fluorouracil's traditional monopoly in chemotherapy.

FAQs

1. What recent clinical developments have impacted fluorouracil's use in cancer therapy?

Recent trials have focused on improved formulations, such as liposomal or topical fluorouracil, and combination strategies with immunotherapies, expanding its indications and reducing side effects.

2. How does the market size of fluorouracil compare to other chemotherapeutic agents?

While still significant, fluorouracil's market is modest relative to newer targeted agents, but its low cost and established efficacy sustain its core role, particularly in low-resource settings.

3. What are the primary challenges facing fluorouracil's market growth?

Emerging targeted therapies, toxicity concerns, and competition from immunotherapies could limit fluorouracil's market share in certain clinical indications.

4. Are there any new formulations of fluorouracil under development?

Yes. Liposomal, nanoparticle, and topical formulations are in clinical trials, aiming to enhance delivery, efficacy, and safety profiles.

5. How will advancements in personalized medicine influence fluorouracil's future?

Personalized approaches, including biomarker-driven treatment selection, may optimize fluorouracil's use, mitigate toxicity, and sustain its relevance amid innovative therapies.


References

  1. ClinicalTrials.gov
  2. Smith J., et al. Liposomal Fluorouracil in Cancer Treatment. Journal of Oncology Research, 2022.
  3. FDA. Topical Fluorouracil Approvals. 2021.
  4. MarketWatch. "Global Fluorouracil Market Size and Forecasts," 2023.

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