Recent experience with oxaliplatin or irinotecan combined with 5-fluorouracil and leucovorin in the treatment of colorectal cancer

Abstract

During the last decade, considerable progress has been made in the development of 5-fluorouracil/leucovorin (5-FU/LV) regimens that optimize antitumor efficacy while minimizing toxicity in the management of colorectal cancer. The use of continuous infusions allowed the administration of high doses of 5-FU and LV, leading to enhanced efficacy with acceptable toxicity. Furthermore, the relatively low toxicity of such regimens as bimonthly 5-FU/LV has provided the opportunity to add other antitumor agents, oxaliplatin and irinotecan, with the possibility of improving tumor response rates and patient survival. The availability of these novel agents provides additional therapeutic options for tumors that are resistant to 5-FU/LV regimens. Several studies have shown that combinations with irinotecan or oxaliplatin have improved response rates and survival over 5-FU/LV regimens alone in first-line therapy of advanced colorectal cancer. Other trials currently in progress attempt to identify whether these new chemotherapeutic regimens can improve survival in the adjuvant setting.