Developments in combination chemotherapy for colorectal cancer

In the last 5 years, major advances have occurred in the treatment of colorectal cancer. Following a period of over 30 years in which 5-fluorouracil was the only proven treatment for colorectal cancer, survival for patients with metastatic colorectal cancer has nearly doubled following the introduction of irinotecan (Campto, Aventis) and oxaliplatin (Eloxatin, Sanofi-Synthelabo). Furthermore, recent studies have demonstrated additional improvements in response and survival when combination chemotherapy drugs are administered with biologic agents that target angiogenesis and tumor growth pathways. The benefit of these newer drugs is now being realized in the adjuvant setting, where the addition of oxaliplatin to infusional 5-fluorouracil/leucovrin has led to improvements in disease-free survival. Further adjuvant studies are testing the benefit of the addition of biologic therapies to oxaliplatin and irinotecan-based combination chemotherapy.