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Related Experiment Videos

Gastrointestinal toxicity or irinotecan

J R Hecht1

  • 1Division of Hematology-Oncology, UCLA School of Medicine, USA.

Oncology (Williston Park, N.Y.)
|September 3, 1998
PubMed
Summary

Irinotecan chemotherapy causes severe diarrhea, a limiting side effect. While early cholinergic symptoms are manageable, late-onset diarrhea requires high-dose loperamide, and further research is needed for better treatments.

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Area of Science:

  • Oncology
  • Pharmacology

Background:

  • Irinotecan (CPT-11) is a chemotherapy agent effective against various carcinomas.
  • Gastrointestinal toxicities, especially diarrhea, hinder irinotecan's widespread clinical application.

Purpose of the Study:

  • To summarize the clinical toxicities of irinotecan, focusing on gastrointestinal side effects.
  • To discuss management strategies for irinotecan-induced diarrhea and identify areas for future research.

Main Methods:

  • Review of clinical data and literature on irinotecan (CPT-11) and its metabolite SN-38.
  • Analysis of the mechanisms and clinical presentation of early and late-onset diarrhea.

Main Results:

  • Early cholinergic syndrome, linked to acetylcholinesterase inhibition, is treatable with atropine.
  • Late-onset diarrhea affects most patients, with 40% experiencing severe (NCI grade 3 or 4) episodes.
  • Late diarrhea is associated with SN-38, irinotecan's active metabolite, and its biliary excretion.

Conclusions:

  • High-dose loperamide can mitigate late diarrhea but does not eliminate patient morbidity.
  • Further investigation into the mechanisms of irinotecan-induced late diarrhea is crucial for developing novel therapeutic approaches.

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