The role of new agents in the treatment of colorectal cancer

Research output: Contribution to journalReview articleContributedpeer-review

Contributors

Abstract

New drugs improved efficacy or convenience of treatment in metastatic colorectal cancer. The oral fluoropyrimidines capecitabine and UFT are less toxic but equally efficacious relative to intravenous bolus 5-fluorouracil (5-FU)/folinic acid (FA). These agents might be beneficial for patients who unlikely benefit from the more intensive combination therapy with infusional 5-FU/FA and irinotecan or oxaliplatin. First-line therapy with irinotecan or oxaliplatin and 5-FU/FA induces an objective response in up to 50% of the patients and may allow neoadjuvant concepts in unresectable liver metastasis. The combination therapy increased progression-free survival and in the case of irinotecan/5-FU/FA also overall survival when compared to 5-FU/FA. Sequential treatment with infusional 5-FU/FA plus oxaliplatin followed by 5-FU/FA plus irinotecan or vice versa results in a median survival exceeding 20 months. Thus, patients in a good performance status and with favorable prognostic parameters should be offered first-line combination treatment of irinotecan or oxaliplatin with 5-FU/FA, whereby 5-FU is preferably administered as an infusion for combination therapy. New targets in the treatment of colorectal cancer are the EGF and VEGF receptor. The monoclonal EGF receptor antibody cetuximab alone and in combination with irinotecan is active in second-line treatment. The VEGF antibody bevacizumab prolongs survival when given in combination with 5-FU/FA and irinotecan.

Details

Original languageEnglish
Pages (from-to)1-17
Number of pages17
JournalOncology
Volume66
Issue number1
Publication statusPublished - 2004
Peer-reviewedYes

External IDs

Scopus 1642525642
PubMed 15031593
ORCID /0000-0002-9321-9911/work/142251930

Keywords

Sustainable Development Goals

Keywords

  • Antibodies, Monoclonal/therapeutic use, Antibodies, Monoclonal, Humanized, Antineoplastic Agents/therapeutic use, Antineoplastic Combined Chemotherapy Protocols/therapeutic use, Camptothecin/analogs & derivatives, Capecitabine, Cetuximab, Clinical Trials as Topic, Colorectal Neoplasms/drug therapy, Deoxycytidine/analogs & derivatives, Fluorouracil/analogs & derivatives, Humans, Irinotecan, Organoplatinum Compounds/therapeutic use, Oxaliplatin, Randomized Controlled Trials as Topic, Survival Analysis, Tegafur/therapeutic use, Treatment Outcome, Uracil/therapeutic use