Review of oxaliplatin: an active platinum agent in colorectal cancer

Oxaliplatin is a novel platinum analogue which has wide spectrum anti-cancer activity in in vitro systems. It has distinct biochemical, pharmacological and cytotoxic properties which are different from those of cisplatin and carboplatin. Importantly, it appears to have distinct mechanisms of resistance such that traditionally platinum insensitive tumour types may be susceptible to oxaliplatin. Most notable in this regard is the activity of this agent which has been demonstrated in colorectal cancer. This review concentrates on this aspect of oxaliplatin. Oxaliplatin has modest activity as a single agent in advanced colorectal cancer compared with other novel agents in this disease. However, there appears to be a powerful synergy between oxaliplatin and 5-fluorouracil. Thus, when given together, response rates of over 50% are consistently observed. The combination has now been extensively tested in this disease and has recently led to the regulatory approval for marketing of oxaliplatin in this condition.