According to a respected team of European researchers, the addition of a new chemotherapy agent oxaliplatin to the standard treatment regimen of 5-fluorouracil (5FU) and leucovorin (LV) doubled the response to therapy and significantly prolonged progression-free survival of patients with previously untreated advanced colorectal cancer when compared to leucovorin (LV) and 5-fluorouracil (5FU) alone.
Colon or rectal cancer, sometimes referred to together as colorectal cancer, is a common cancer affecting the colon or the rectum, each part of the body’s digestive system. Colorectal cancer can be treated with surgery, radiation therapy, and/or chemotherapy. The standard chemotherapy used to treat advanced colorectal cancer is 5-fluorouracil and leucovorin. This combination produces significant responses in 14-33% of patients. Even so, the average survival time of persons with metastatic colorectal cancer, (colorectal cancer that has spread to other parts of the body) is less than one year and fewer than 5% of these persons are living 5 years after diagnosis. In an effort to improve the effectiveness of treatment, researchers are investigating new drugs and combinations of therapies.
Oxaliplatin is a novel anti-cancer agent that is the first drug in its class to show significant activity in the treatment of advanced colorectal cancer. Oxaliplatin is a platinum compound, related to the commonly used chemotherapy drugs, cisplatin and carboplatin. When used by itself, oxaliplatin is active producing responses in 10-24% of patients with metastatic colorectal cancer; however, researchers speculate that this new drug may be more effective in combination with other therapies.
In order to evaluate oxaliplatin as first-line treatment in advanced colorectal cancer, an international Phase III clinical trial was performed in which 420 patients, ages 18 to 75 years, were treated at 35 institutions in nine countries. Patients were treated with either the standard regimen of 5-FU/LV or oxaliplatin combined with 5-FU/LV and directly compared.
The results of this trial published in the August
Journal of Clinical Oncology demonstrated that adding oxaliplatin to a regimen of 5FU and LV doubled the number of patients with partial or complete disappearance of cancer and prolonged the average time to cancer progression by 3 months compared to treatment with 5-FU and LV alone. Patients treated with oxaliplatin survived an average of 9 months without cancer progression compared to only 6.2 months for patients treated with 5-FU and LV. This trial demonstrated one of the longest progression-free survival times of any multi-center trial evaluating treatment of metastatic colorectal cancer. Over half of the patients treated with oxaliplatin survived more than14. 7 months compared to 12.1 months for patients treated with 5-FU and LV alone.
Oxaliplatin is an important new treatment option for oncologists, their patients and patient’s family members. Oxaliplatin is currently available in most European countries and is continuing to be evaluated in clinical trials in the United States. Clinical trials are ongoing to determine the best way to utilize oxaliplatin alone or in combination with other anti-cancer agents. Two sources of information on ongoing clinical trials that can be discussed with your doctor include the comprehensive, easy to use clinical listing services provided by the National Institutes of Health (
CancerConsultants.com. CancerConsultants.com also performs personalized clinical trial searches on behalf of patients. (
Journal of Clinical Oncology, Vol 18, No 16, pp 2938-2947, 2000)
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