Irinotecan or oxaliplatin for first-line treatment of advanced colorectal cancer?

Open Access
Publisher Website
Google Scholar
Abstract
In this issue of Annals of Oncology, two studies by the Southern Italy Cooperative Oncology Group (SICOG) and the Hellenic Cooperative Oncology Group (HECOG) are presented in which treatment with irinotecan and oxaliplatin, both in combination with 5-fluorouracil/leucovorin (5-FU/LV), is compared in patients with advanced colorectal cancer [1, 2]. The choice of the first-line regimen may be important, since not all patients are eligible for salvage treatment, which obviously provides a rationale to first administer the most effective treatment. The study by Goldberg et al. [3], which showed an overall survival benefit for FOLFOX when compared with IFL, has convinced many colleagues that oxaliplatin should be the preferred choice. However, both the fact that in this study a bolus 5-FU regimen (IFL) was compared with a prolonged 5-FU infusion regimen (FOLFOX), and the fact that salvage treatment in the IFL arm was inferior to the FOLFOX arm, do not allow such a straightforward conclusion [4]. The GERCOR study in which irinotecan and oxaliplatin were compared using the same schedule of prolonged 5-FU infusion and LV with both drugs did not show any significant differences in response rates or survival [5].

This publication has 10 references indexed in Scilit: