Pharmacology of intraperitoneal CPT-11

CPT-11 is clearly one of the most important new anticancer drugs developed in the last few decades, and CPT-11 combined with 5-fluorouracil (5-FU) and leucovorin is considered as reference first-line chemotherapy in the treatment of metastatic colorectal cancer. CPT-11 has a complex pharmacologic profile in vivo, and it needs caboxylesterase-mediated biotransformation to SN-38 before production of its cytotoxic effect. Intraperitoneal administration of CPT-11 has been studied recently in murine models and presented some potential advantage over the intravenous (i.v.) route. Intraperitoneal administration of CPT-11 may be more effective than i.v. administration not only for peritoneal seeding but also for liver metastases. Also, these effects may occur with less toxicity by intraperitoneal administration. Intraperitoneal chemotherapy containing CPT-11 might be an essential option for prevention and treatment of cancerous dissemination of gastrointestinal malignancy.