Integrating the oral fluoropyrimidines into the management of advanced colorectal cancer

European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)
D Cunningham, R D James

Abstract

In colorectal cancer, leucovorin-modulated 5-fluorouracil (5-FU) has been the mainstay of both adjuvant treatment and treatment of metastatic disease for many years. In advanced disease, response rates of 10-43% are reported; efforts to improve efficacy through schedule modification, including prolonged infusions, have led to limited success. New agents with improved efficacy, tolerability and ease of administration are required. Among the newer drugs, irinotecan and oxaliplatin are becoming established as first- and second-line treatment for advanced disease. Their novel mechanisms of action have proven to be of value in 5-FU-resistant patients. In tandem with these developments, thymidylate synthase inhibition has remained an important objective and oral fluoropyrimidines such as capecitabine and UFT (uracil plus tegafur)/leucovorin have been developed with this goal in mind. Two large, phase III studies of capecitabine in metastatic disease demonstrated objective response rates of 26.6 and 24.8%. UFT/leucovorin has also been evaluated in phase III trials, with an 11.7% response rate reported. Both agents are being evaluated in combination with oxaliplatin and irinotecan, and ultimately oral fluoropyrimidines as monotherapy o...Continue Reading

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Citations

Jul 15, 2015·Expert Opinion on Therapeutic Patents·Esmeralda CarrilloJuan Antonio Marchal
Apr 10, 2004·Cancer·Ada H BraunPeter Preusser
Nov 17, 2007·Molecules : a Journal of Synthetic Chemistry and Natural Product Chemistry·Fu-Min ZhangYong-Qiang Tu
Dec 11, 2007·Molecules : a Journal of Synthetic Chemistry and Natural Product Chemistry·Zhi-Yong TianChao-Jie Wang

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