The potential role of Tomudex in the treatment of advanced colorectal cancer.
OBJECTIVE
The quinazoline folate analog thymidylate synthase inhibitor, Tomudex, is about to enter the Italian pharmaceutical market. Its place among the therapeutic options for advanced colorectal cancer is discussed.


METHODS
The pros and cons of currently available chemotherapeutic regimens are briefly described with special attention to patient's and tumor's determinants of treatment outcome. The mechanism of action and the results of phase I, II and III studies of Tomudex are reviewed.


RESULTS
Not all patients need to be treated. Guidelines are given in this respect. Tomudex at the dose of 3 mg/m2 given i.v. every three weeks has antitumor activity similar to that of currently available regimens, with a favorable toxicity profile.


CONCLUSIONS
Current research approaches are unlikely to dramatically improve the treatment outcome of this disease in the near future. What can reasonably be expected is less toxicity and more convenient routes and schedules of drug administration that may translate into better quality of life for our patients. Tomudex has been devised along these lines.
Sobrero
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AF
Cattedra di Oncologia Medica, Università di Firenze, Italy.
D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use*; D017321:Clinical Trials, Phase I as Topic; D017322:Clinical Trials, Phase II as Topic; D015179:Colorectal Neoplasms / Q000188:drug therapy*; D005472:Fluorouracil / Q000627:therapeutic use; D006801:Humans; D002955:Leucovorin / Q000627:therapeutic use; D011799:Quinazolines / Q000494:pharmacology / Q000627:therapeutic use*; D013876:Thiophenes / Q000494:pharmacology / Q000627:therapeutic use*; D013940:Thymidylate Synthase / Q000037:antagonists & inhibitors*
D000964:Antimetabolites, Antineoplastic; D011799:Quinazolines; D013876:Thiophenes; D013940:Thymidylate Synthase; C068874:raltitrexed; D002955:Leucovorin; D005472:Fluorouracil