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[Progress in chemotherapy for colorectal cancer]
1Department of Chemotherapy, Tokyo Metropolitan Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo 113-8677, Japan.
Gan to Kagaku Ryoho. Cancer & Chemotherapy
|January 6, 2001
Summary
Leucovorin plus 5-fluorouracil (LV/5-FU) chemotherapy significantly improved survival in advanced colorectal cancer patients. Newer oral chemotherapy options offer comparable efficacy with better tolerability, enhancing patient quality of life.
Area of Science:
- Oncology
- Gastroenterology
- Pharmacology
Background:
- Colorectal cancer (CRC) with recurrent or metastatic sites presents significant treatment challenges.
- Leucovorin plus 5-fluorouracil (LV/5-FU) is a recognized standard chemotherapy for CRC.
- Emerging combination therapies and novel oral agents are being investigated to improve outcomes.
Purpose of the Study:
- To evaluate the efficacy of LV/5-FU therapy in prolonging survival for advanced colorectal cancer patients.
- To review the comparative effectiveness and tolerability of novel oral chemotherapy agents against standard LV/5-FU therapy.
- To highlight ongoing clinical trials exploring combinations of oral agents with other chemotherapeutics.
Main Methods:
- Retrospective analysis comparing survival in patients receiving LV/5-FU versus best supportive care.
- Review of randomized studies comparing LV/5-FU with newer regimens (e.g., LV/5-FU plus oxaliplatin, LV/5-FU plus CPT-11).
- Assessment of clinical data on new oral drugs (Capecitabine, UFT/LV, S-1) regarding antitumor activity and tolerability.
Main Results:
- LV/5-FU therapy demonstrated a significant survival benefit compared to best supportive care in advanced CRC.
- Newer oral agents (Capecitabine, UFT/LV, S-1) show comparable antitumor activity to LV/5-FU.
- Oral agents exhibit superior tolerability, improving quality of life, particularly for elderly patients.
Conclusions:
- LV/5-FU remains an effective standard for advanced colorectal cancer, significantly improving survival.
- Novel oral chemotherapy drugs represent a promising advancement, offering comparable efficacy with improved tolerability and quality of life.
- Further clinical investigations combining oral agents with other chemotherapeutics (CDDP, CPT-11) are warranted and hold significant future potential.