Levamisole as a therapeutic agent for colorectal carcinoma.
The prognosis of colon cancer patients found to have lymph node involvement at the time of primary surgical resection is guarded, with an overall 5-year survival rate of approximately 33%. The compound 5-fluorouracil (5-FU), an antimetabolite with some clinical activity in patients with metastatic colorectal cancer, has failed to produce a clinically meaningful impact when used as a single agent in the adjuvant setting. Recently, the results of a definitive intergroup trial (Moertel et al., N. Engl. J. Med. 322: 352-358, 1990) confirmed the results of a smaller trial that had suggested a therapeutic benefit from the combination of 5-FU and levamisole (Lev), an anthelminthic with immunomodulatory properties; these results have defined a new standard of care for patients with node-positive colon cancer. In this review, the rationale for using Lev as an adjuvant to 5-FU therapy in colon cancer, the immunologic effects of Lev in preclinical and clinical studies, and the results of clinical trials will be discussed.
Division of Cancer Treatment, National Cancer Institute, Bethesda, Maryland 20892.
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JL
Grem
D000818:Animals; D002986:Clinical Trials as Topic; D015179:Colorectal Neoplasms / Q000188:drug therapy*; D006801:Humans; D007978:Levamisole / Q000627:therapeutic use*
D007978:Levamisole