title: Triplet combination of fluoropyrimidines, oxaliplatin, and irinotecan in the first-line treatment of metastatic colorectal cancer.
abstract: In recent years, the treatment of metastatic colorectal cancer has improved because of the availability of 3 active cytotoxic drugs, 2 monoclonal antibodies, and the expanded use of surgery on metastases in selected patients, leading to a median overall survival of almost 2 years. Chemotherapy remains the primary option for these patients, and the development of first-line chemotherapy regimens associated with higher activity and improved efficacy is still a major topic of interest. This article provides an overview of the development of a first-line treatment combination of irinotecan and oxaliplatin plus 5-fluorouracil (5-FU; FOLFOXIRI) or oral fluoropyrimidines in patients with metastatic colorectal cancer, evaluating the feasibility and the activity of these regimens in phase I/II studies and the results of a recent phase III study that demonstrates that FOLFOXIRI significantly increases response rate, radical surgical resection of metastases, progression-free survival, and overall survival compared with an infusional 5-FU-containing doublet such as FOLFIRI (5-FU/leucovorin/irinotecan).
authors.affiliation: Department of Oncology, Azienda USL 6 of Livorno, Istituto Toscano Tumori, Livorno, Italy. gl.masi@tin.it
authors.forename: Gianluca
authors.initials: G
authors.lastname: Masi
authors.forename: Enrico
authors.initials: E
authors.lastname: Vasile
authors.forename: Fotios
authors.initials: F
authors.lastname: Loupakis
authors.forename: Simona
authors.initials: S
authors.lastname: Bursi
authors.forename: Sergio
authors.initials: S
authors.lastname: Ricci
authors.forename: Iacopo
authors.initials: I
authors.lastname: Petrini
authors.forename: Andrea
authors.initials: A
authors.lastname: Fontana
authors.forename: Giacomo
authors.initials: G
authors.lastname: Allegrini
authors.forename: Alfredo
authors.initials: A
authors.lastname: Falcone
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives; D002986:Clinical Trials as Topic; D015179:Colorectal Neoplasms / Q000188:drug therapy*; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D000077146:Irinotecan; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D000077150:Oxaliplatin
chemical_list: D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D000077146:Irinotecan; D005472:Fluorouracil; D002166:Camptothecin