Raltitrexed-based chemotherapy for advanced colorectal cancer

Area of Science:

• Oncology
• Clinical Pharmacology

Background:

• Advanced colorectal cancer (CRC) necessitates effective chemotherapy regimens.
• 5-fluorouracil (5-FU)-based chemotherapy is a traditional standard for CRC treatment.
• Novel agents like raltitrexed are explored to improve efficacy and safety profiles.

Purpose of the Study:

• To evaluate the efficacy and safety of raltitrexed-based chemotherapy versus 5-FU-based chemotherapy in advanced CRC.
• To compare overall survival, overall response rate, and toxicity profiles between the two regimens.

Main Methods:

• A meta-analysis of 11 randomized controlled trials involving 4622 patients with advanced CRC.
• Electronic literature search to identify relevant studies comparing raltitrexed-based and 5-FU-based regimens.
• Outcomes assessed included overall survival, overall response rate, and various toxicities.

Main Results:

• No significant difference in overall survival (HR=1.06) or overall response rate (RR=1.09) between raltitrexed and 5-FU regimens.
• Raltitrexed/oxaliplatin showed higher partial response (RR=1.53), overall response rate (RR=1.42), and disease control (RR=1.16) versus 5-FU/leucovorin/oxaliplatin.
• Raltitrexed arm had increased severe anemia, asthenia, hepatic disorders, and nausea/vomiting.
• 5-FU group showed higher rates of alopecia and stomatitis/mucositis.

Conclusions:

• Raltitrexed-based chemotherapy offers equivalent overall survival and response rates to 5-FU-based regimens in advanced CRC.
• Raltitrexed presents a viable treatment option for patients intolerant to or unsuitable for 5-FU-based therapies.
• The toxicity profiles differ, with raltitrexed associated with hematologic and hepatic issues, while 5-FU is linked to mucositis and alopecia.