[Irinotecan--experience with second-line treatment in advanced colorectal cancer]

The prognosis for patients with advanced colorectal cancer who fail to respond to a 5-FU based therapy is poor. About 7% response rate can be achieved with second line therapeutic regiments, the overall survival is about 6-7 months. The aim of authors was to assess the efficacy and toxicity profile of irinotecan (CAMPTO) in patients with advanced colorectal cancer, resistant to 5-FU based chemotherapy. From October 1996 to November 1998 19 previously treated metastatic colorectal cancer patients with documented progression were recruited. Irinotecan was given at a dose of 350 mg/m2 i.v. over 90 min. every 3 week. Tumor response and toxicity were assessed using WHO criteria. Median age: 59.7 years (42-72). Tumor sites: 12/19 colon, 7/19 rectum. 11/19 patients had 1 metastatic site, 8/19 had 2 or more metastatic sites. CR: 0/19, PR: 3/19, MR: 2/19, SD: 10/19, PD: 4/19. Median time to progression was 9.1 months (range 1.5-22). The overall median survival was 15.5 months (range 2.5-37). Grade 3-4 delayed diarrhoea occurred in 26.3% of patients. Grade 3 neutropenia occurred in 15.7% of patients. Preliminary results confirm the clinical value of irinotecan in 5-FU resistant metastatic colorectal cancer with tolerable toxicity profile. Irinotecan should be considered as the basic chemotherapeutic agent for second line treatment of metastatic colorectal cancer.