Oxaliplatin: a new therapeutic option in colorectal cancer

Oxaliplatin (Eloxatin; Sanofi, Gentilly, France), a third-generation platinum compound with a 1,2-diaminocyclohexane (DACH) carrier ligand, is a recently developed agent with activity in colorectal cancer (CRC). Preclinical and clinical observations demonstrate synergistic effects with 5-fluorouracil (5-FU), even in 5-FU-resistant tumors. The supradditive pharmacodynamics of the combination have also been proven in previously untreated CRC patients in controlled phase III trials. Due to its excellent safety profile, unique mechanism of action, and lack of cross-resistance with other CRC chemotherapeutic agents, oxaliplatin can be combined with 5-FU, irinotecan (CPT-II), raltitrexed, or other agents. Future directions of development are to determine the optimal administration scheme and the most effective combinations of oxaliplatin with 5-FU or with other anticancer agents. Ongoing controlled studies in adjuvant therapy will further define the place of oxaliplatin in the treatment of CRC.