Irinotecan in the Treatment of Colorectal Cancer: Clinical Overview
Top Cited Papers
- 1 March 2001
- journal article
- review article
- Published by American Society of Clinical Oncology (ASCO) in Journal of Clinical Oncology
- Vol. 19 (5) , 1501-1518
- https://doi.org/10.1200/jco.2001.19.5.1501
Abstract
PURPOSE AND METHODS: For more than three decades, the therapeutic options for patients with advanced colorectal cancer have almost exclusively been based on fluoropyrimidines. With the recognition that topoisomerase-I (TOP-I) is an important therapeutic target in cancer therapy, irinotecan, a semisynthetic TOP-I–interactive camptothecin derivative, has been clinically established in the treatment of colorectal cancer. RESULTS: Irinotecan was investigated as second-line chemotherapy after prior treatment with fluorouracil (FU)-based regimens in two large randomized phase III trials comparing irinotecan with either best supportive care or an infusional FU/leucovorin (LV) regimen. The outcomes of these trials established irinotecan as the standard therapy in the second-line treatment of colorectal cancer. The therapeutic value of irinotecan in the first-line treatment of metastatic colorectal cancer was investigated in two large randomized phase III trials comparing the combination of irinotecan and FU/LV with FU/LV alone. Both trials demonstrated significant superior efficacy for the combination of irinotecan and FU/LV in terms of response rate, median time to disease progression, and median survival time. Consequently, the combination of irinotecan and FU/LV has been approved as first-line chemotherapy for patients with metastatic colorectal cancer and constitutes the reference therapy against which other treatment options must be tested in the future. CONCLUSION: In this review, the clinical rationale and update of the present clinical status of irinotecan in the treatment of colorectal cancer and future prospects of irinotecan-based combinations are discussed.Keywords
This publication has 119 references indexed in Scilit:
- Folinic acid (FA) and 5-fluorouracil (FU) alone or with irinotecan (CPT-11) for advanced colorectal cancer (ACC): Preliminary results of a randomized phase II trialEuropean Journal Of Cancer, 1999
- A randomized phase II trial assessing irinotecan (IRI) and 5FU/folinic acid (LV), “Mayo regimen”, in first line palliative chemotherapy patients (pts) with metastatic colorectal cancer (MCRC)European Journal Of Cancer, 1999
- Phase I dose finding study with irinotecan (CPT-11) in cancer patients (pts) with hepatic dysfynctionEuropean Journal Of Cancer, 1999
- CPT-11 (Irinotecan) addition to bimonthly, high-dose leucovorin and bolus and continuous-infusion 5-fluorouracil (FOLFIRI) for pretreated metastatic colorectal cancerEuropean Journal Of Cancer, 1999
- 6. Topoisomerase inhibitorsAnnals of Oncology, 1998
- CPT-11 in human colon-cancer cell lines and xenografts: Characterization of cellular sensitivity determinantsInternational Journal of Cancer, 1997
- Structural characterization of the human DNA topoisomerase I gene promoterEuropean Journal of Biochemistry, 1990
- Protein kinase C phosphorylates DNA topoisomerase IFEBS Letters, 1989
- Nonproductive Rearrangement of DNA Topoisomerase I and II Genes: Correlation With Resistance to Topoisomerase InhibitorsJNCI Journal of the National Cancer Institute, 1989
- Gene expression in regenerating liver in relation to cell proliferation and stressEuropean Journal of Biochemistry, 1989