The colon and rectum are parts of the body’s digestive system that together form a long muscular tube called the large intestine. Cancers of the colon and rectum sometimes referred to together as colorectal cancer are characterized by the presence of cancerous cells in the colon and rectum. One standard chemotherapy drug used for the treatment of metastatic (cancer has spread to different sites in the body) colorectal cancer is 5-fluourouracil (5-FU), which is usually administered intravenously (in the vein). This treatment produces significant responses in many patients, but intravenous administration can be difficult and the average survival time of persons with metastatic colorectal cancer is still less than one year. Results from a recent study published in the Journal of Clinical Oncology have indicated that a drug called Eniluracil appears to prolong the anti-cancer activity of orally administered 5-FU, allowing easier administration of 5-FU while sustaining effectiveness.
Historically, the most effective way to administer 5-FU was through continuous intravenous infusion, which usually required a central venous catheter (a small tube through which medicine was administered, placed in a vein near the heart for an extended period of time). This treatment increases the risk for infection, is cumbersome and very expensive. Due to the negative aspects of intravenous infusion of 5-FU, research has been focused on trying to improve the effectiveness of an oral form of 5-FU. A recent study showed that the use of Eniluracil prolongs the anti-cancer activity of orally administered 5-FU and is just as effective as 5-FU administered intravenously.
Researchers at several medical centers treated 55 patients with advanced colorectal cancer with the combination of oral 5-FU and Eniluracil. Approximately 25% of the patients showed a response to the treatment, with an average survival time of 59 weeks. These doctors concluded that response rates and survival times produced by the combination of oral 5-FU and Eniluracil were comparable to treatment with intravenous 5-FU. In addition, patients receiving oral 5-FU were able to be treated in a home based setting, compared to the required hospitalization for patients receiving intravenous 5-FU treatment.
Persons with advanced colorectal cancer may wish to talk to their physicians about the risks and benefits of participating in a clinical trial further evaluating the treatment combination of oral 5-FU and Eniluracil or other promising new treatments. Two sources of information on ongoing clinical trials that can be discussed with a doctor include a comprehensive, easy to use service provided by the National Cancer Institute (cancer.gov) and eCancerTrials.com. eCancerTrials.com performs personalized clinical trial searches on behalf of patients. (Journal of Clinical Oncology, Vol 18, No 15, pp 2894-2901, 2000)