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New Chemotherapeutic Strategies in Colorectal Cancer

  • Conference paper
Rectal Cancer Treatment

Part of the book series: Recent Results in Cancer Research ((RECENTCANCER,volume 165))

Abstract

Since colorectal cancer is the second most prevalent cancer worldwide, its treatment remains a major challenge for researchers, gastroenterologists and oncologists. Despite curative resections, half of all patients diagnosed with colorectal cancer die because of their underlying disease. Integral chemotherapeutic components of standard regimens are 5-fluorouracil (5-FU), its modulation by folinic acid and irinotecan or oxaliplatin. All these drugs sequentially given have results in terms of median overall survival of more than 20 months in the palliative treatment of advanced colorectal cancer. Oral fluoropyrimidines, currently under clinical investigation, are likely to substitute continuous 5-FU. Inhibitors of growth factor receptors or their signaling may further prolong disease-free and overall survival rates. Preliminary evidence exists that improved adjuvant and neoadjuvant chemotherapy strategies may further improve the prognosis, mainly because more patients are able to go for primary or secondary surgery with curative intent.

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References

  1. Parkin DM (2001) Global cancer statistics in the year 2000. Lancet Oncol 2:533–543

    Article  PubMed  Google Scholar 

  2. Landis SH, Murray T, Bolden S, Wingo PA (1999) Cancer statistics, 1999. CA Cancer J Clin 49:8–31

    PubMed  Google Scholar 

  3. Anonymous (1992) Modulation of fluorouracil by leucovorin in patients with advanced colorectal cancer: evidence in terms of response rate. Advanced Colorectal Cancer Meta-Analysis Project. J Clin Oncol 10:896–903

    Google Scholar 

  4. Poon MA et al (1989) Biochemical modulation of fluorouracil: evidence of significant improvement of survival and quality of life in patients with advanced colorectal carcinoma. J Clin Oncol 7:1407–1418

    PubMed  Google Scholar 

  5. Poon MA et al (1991) Biochemical modulation of fluorouracil with leucovorin: confirmatory evidence of improved therapeutic efficacy in advanced colorectal cancer. J Clin Oncol 9:1967–1972

    PubMed  Google Scholar 

  6. Patel K et al (2004) Weekly 5-fluorouracil and leucovorin: achieving lower toxicity with higher dose-intensity in adjuvant chemotherapy after colorectal cancer resection. Ann Oncol 15:568–573

    Article  PubMed  Google Scholar 

  7. Anonymous (1998) Efficacy of intravenous continuous infusion of fluorouracil compared with bolus administration in advanced colorectal cancer. Meta-analysis Group In Cancer. J Clin Oncol 16:301–308

    Google Scholar 

  8. Goldberg RM et al (2004) A randomized controlled trial of fluorouracil plus leucovorin, irinotecan, and oxaliplatin combinations in patients with previously untreated metastatic colorectal cancer. J Clin Oncol 22:23–30

    Article  PubMed  Google Scholar 

  9. Tournigand C et al (2004) FOLFIRI followed by FOLFOX6 or the reverse sequence in advanced colorectal cancer: a randomized GERCOR study. J Clin Oncol 22:229–237

    Article  PubMed  Google Scholar 

  10. Moertel CG (1994) Chemotherapy for colorectal cancer. N Engl J Med 330:1136–1142

    Article  PubMed  Google Scholar 

  11. Maughan TS (2001) Adjuvant chemotherapy for colorectal cancer. Br J Cancer 85:1422–1424

    Article  PubMed  Google Scholar 

  12. Mamounas E et al (1999) Comparative efficacy of adjuvant chemotherapy in patients with Dukes' B versus Dukes' C colon cancer: results from four National Surgical Adjuvant Breast and Bowel Project adjuvant studies (C-01, C-02, C-03, and C-04). J Clin Oncol 17:1349–1355

    PubMed  Google Scholar 

  13. Anonymous (1999) Efficacy of adjuvant fluorouracil and folinic acid in B2 colon cancer. International Multicentre Pooled Analysis of B2 Colon Cancer Trials (IMPACT B2) Investigators. J Clin Oncol 17:1356–63

    Google Scholar 

  14. Maung K (2003) Integrating oxaliplatin and capecitabine in adjuvant therapy of high-risk colorectal cancer. Clin Colorectal Cancer 3:150–153

    PubMed  Google Scholar 

  15. Andre T, Boni C, Mounedji-Boudiaf L, Navarro M, Tabernero J, Hickish T, Topham C, Zaninelli M, Clingan P, Bridgewater J, Tabah-Fisch I, de Gramont A; Multicenter International Study of Oxaliplatin/5-Fluorouracil/Leucovorin in the Adjuvant Treatment of Colon Cancer (MOSAIC) Investigators (2004) Oxaliplatin, fluorouracil, and leucovorin as adjuvant treatment for colon cancer. N Engl J Med 350:2343–2351

    Google Scholar 

  16. Wils J, O'Dwyer P, Labianca R (2001) Adjuvant treatment of colorectal cancer at the turn of the century: European and US perspectives. Ann Oncol 12:13–22

    Article  PubMed  Google Scholar 

  17. Saltz LB et al (2000) Irinotecan plus fluorouracil and leucovorin for metastatic colorectal cancer. Irinotecan Study Group. N Engl J Med 343:905–914

    Article  PubMed  Google Scholar 

  18. Douillard JY et al (2000) Irinotecan combined with fluorouracil compared with fluorouracil alone as first-line treatment for metastatic colorectal cancer: a multicentre randomised trial. Lancet 355:1041–1047

    Article  PubMed  Google Scholar 

  19. Giacchetti S et al (2000) Phase III multicenter randomized trial of oxaliplatin added to chronomodulated fluorouracil-leucovorin as first-line treatment ofmetastatic colorectal cancer. J Clin Oncol 18:136–47

    PubMed  Google Scholar 

  20. De Gramont A et al (2000) Leucovorin and fluorouracil with or without oxaliplatin as first-line treatment in advanced colorectal cancer. J Clin Oncol 18:2938–2947

    PubMed  Google Scholar 

  21. Sobrero A et al (2000) New directions in the treatment of colorectal cancer: a look to the future. Eur J Cancer 36:559–566

    Article  PubMed  Google Scholar 

  22. Heslin MJ et al (2003) Dihydropyrimidine dehydrogenase (DPD) rapidly regenerates after inactivation by eniluracil (GW776C85) in primary and metastatic colorectal cancer. Cancer Chemother Pharmacol 52:399–404

    Article  PubMed  Google Scholar 

  23. Wilke H (2002) Future treatment options with capecitabine in solid tumours. Eur J Cancer 38[Suppl 2]:21–25

    Article  PubMed  Google Scholar 

  24. Van Cutsem E et al (2001) Oral capecitabine compared with intravenous fluorouracil plus leucovorin in patients with metastatic colorectal cancer: results of a large phase III study. J Clin Oncol 19:4097–4106

    PubMed  Google Scholar 

  25. Grothey A, Schmoll HJ (2001) New chemotherapy approaches in colorectal cancer. Curr Opin Oncol 13:275–286

    Article  PubMed  Google Scholar 

  26. Rothenberg ML (2002) Current status of capecitabine in the treatment of colorectal cancer. Oncology (Huntingt) 16:16–22

    Google Scholar 

  27. Kerr D (2002) Capecitabine/irinotecan in colorectal cancer: European early-phase data and planned trials. Oncology (Huntingt) 16:12–15

    Google Scholar 

  28. Folprecht G, Kohne CH (2004) The role of new agents in the treatment of colorectal cancer. Oncology 66:1–17

    Article  PubMed  Google Scholar 

  29. Baselga J, Albanell J (2002) Epithelial growth factor receptor interacting agents. Hematol Oncol Clin North Am 16:1041–1063

    Article  PubMed  Google Scholar 

  30. Tebbutt NC, Cattell E, Midgley R, Cunningham D, Kerr D (2002) Systemic treatment of colorectal cancer. Eur J Cancer 38:1000–1015

    Article  PubMed  Google Scholar 

  31. Herbst RS, Kim ES, Harari PM (2001) IMC-C225, an anti-epidermal growth factor receptor monoclonal antibody, for treatment of head andneck cancer. Expert Opin Biol Ther 1:719–732

    Article  PubMed  Google Scholar 

  32. Saltz LB et al (2004) Phase II trial of cetuximab in patients with refractory colorectal cancer that expresses the epidermal growth factor receptor. J Clin Oncol 22:1201–1208

    Article  PubMed  Google Scholar 

  33. Cunningham D, Humblet Y, Siena S, Khayat D, Bleiberg H, Santoro A, Bets D, Mueser M, Harstrick A, Verslype C, Chau I, Van Cutsem EN (2004) Cetuximab monotherapy and cetuximab plus irinotecan in irinotecan-refractory metastatic colorectal cancer. Engl J Med 351:337–345

    Article  PubMed  Google Scholar 

  34. Taberno JM et al (2004) An international phase II study of cetuximab in combination with oxaliplatin/5-fluorouracil (5-FU)/folinic acid (FA) (FOLFOX-4) in the first-line treatment of patients with metastatic colorectal cancer (CRC) expressing Epidermal Growth Factor Receptor (EGFR). Preliminary results (abstract). Proceedings of ASCO 22:3512

    Google Scholar 

  35. Rougier P et al (2004) Cetuximab+FOLFIRI as first-line treatment for metastatic colorectal CA (abstract). Proceedings of ASCO, 22:3513

    Google Scholar 

  36. Douglass EC (2003) Development of ZD1839 in colorectal cancer. Semin Oncol 30:17–22

    Article  Google Scholar 

  37. Kabbinavar F et al (2003) Phase II, randomized trial comparing bevacizumab plus fluorouracil (FU)/leucovorin (LV) with FU/LV alone in patients with metastatic colorectal cancer. J Clin Oncol 21:60–65

    Article  PubMed  Google Scholar 

  38. Hurwitz HLF et al (2004) Bevacizumab plus irinotecan, fluorouracil, and leucovorin for metastatic colorectal cancer.. N Engl J Med 350:2335–2342

    Article  PubMed  Google Scholar 

  39. Bismuth H et al (1996) Resection of nonresectable liver metastases from colorectal cancer after neoadjuvant chemotherapy. Ann Surg 224:509–520; discussion 520–522

    Article  PubMed  Google Scholar 

  40. Giovannini M Percutaneous alcohol ablation for liver metastasis. Semin Oncol 29:192–5 (2002)

    Google Scholar 

  41. Livraghi T et al (2003) Treatment of focal liver tumors with percutaneous radio-frequency ablation: complications encountered in a multicenter study. Radiology 226:441–451

    PubMed  Google Scholar 

  42. Kessler A et al (2002) Minimally invasive techniques in the treatment of liver tumors. Isr Med Assoc J 4:1106–1110

    PubMed  Google Scholar 

  43. Scaife CL et al (2003) Feasibility of adjuvant hepatic arterial infusion of chemotherapy after radiofrequency ablation with or without resection in patients with hepatic metastases from colorectal cancer. Ann Surg Oncol 10:348–354

    Article  PubMed  Google Scholar 

  44. Pozzo C, Basso M, Cassano A, Quirino M, Schinzari G, Trigila N, Vellone M, Giuliante F, Nuzzo G, Barone C (2004) Neoadjuvant treatment of unresectable liver desease with irinotecan and 5-fluorouracil plus folinic acid in colorectal cancer patients. Ann Oncol 15:933–939

    Article  PubMed  Google Scholar 

  45. Giacchetti S et al (1999) Long-term survival of patients with unresectable colorectal cancer liver metastases following infusional chemotherapy with 5-fluorouracil, leucovorin, oxaliplatin and surgery. Ann Oncol 10:663–669

    Article  PubMed  Google Scholar 

  46. Penna C, Nordlinger B (2003) Surgery and local treatments of liver metastases from colorectal cancer: how to improve results. Scand J Surg 92:90–96

    PubMed  Google Scholar 

  47. Lorenz M et al (1999) Relevance of neoadjuvant and adjuvant treatment for patients with resectable liver metastases of colorectal carcinoma. Langenbecks Arch Surg 384:328–338

    Article  PubMed  Google Scholar 

  48. Rubbia-Brandt L et al (2004) Severe hepatic sinusoidal obstruction associated with oxaliplatin-based chemotherapy in patients with metastatic colorectal cancer. Ann Oncol 15:460–466

    Article  PubMed  Google Scholar 

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© 2005 Springer-Verlag Berlin Heidelberg

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Moehler, M., Teufel, A., Galle, P.R. (2005). New Chemotherapeutic Strategies in Colorectal Cancer. In: Büchler, M.W., Weitz, J., Ulrich, B., Heald, R.J. (eds) Rectal Cancer Treatment. Recent Results in Cancer Research, vol 165. Springer, Berlin, Heidelberg. https://doi.org/10.1007/3-540-27449-9_28

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  • DOI: https://doi.org/10.1007/3-540-27449-9_28

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-23341-1

  • Online ISBN: 978-3-540-27449-0

  • eBook Packages: MedicineMedicine (R0)

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