The role of irinotecan in colorectal cancer.
Irinotecan, also known as CPT-11, is a topoisomerase I inhibitor currently approved for use as a second-line agent in the treatment of advanced colorectal cancer. Preliminary reports from randomized studies exploring combinations of CPT-11 plus 5-fluorouracil have shown improved antitumor activity versus 5-fluorouracil-based treatments alone, and suggest a first-line role for these combination regimens. The role of CPT-11/5-fluorouracil regimens in the adjuvant setting is now being actively explored. Studies of single-agent CPT-11 in the first-line treatment of metastatic colorectal cancer have shown activity; however response rates do not appear to be superior to those seen with standard first-line 5-fluorouracil-based regimens. The use of specific molecular markers as prognostic indicators of response or resistance to specific chemotherapies may, however, permit the identification of a selected population of patients with tumor characteristics that would specifically favor consideration of up-front use of single-agent CPT-11.
Saltz
L B
LB
Gastrointestinal Oncology Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10021, USA.
D000972:Antineoplastic Agents, Phytogenic / Q000009:adverse effects / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002166:Camptothecin / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use*; D015179:Colorectal Neoplasms / Q000188:drug therapy*; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D000077146:Irinotecan; D002955:Leucovorin / Q000008:administration & dosage; D018579:Patient Selection; D059004:Topoisomerase I Inhibitors; D016896:Treatment Outcome
D000972:Antineoplastic Agents, Phytogenic; D059004:Topoisomerase I Inhibitors; D000077146:Irinotecan; D002955:Leucovorin; D005472:Fluorouracil; D002166:Camptothecin