TY - JOUR
T1 - Perspectives in the treatment of colorectal cancer
AU - Ozer, Howard
AU - Diasio, Robert B.
N1 - Funding Information:
Dr Ozer has received research grant support from, is a consultant to, and is a member of the speakers bureau of Amgen. Dr Diasio is a consultant to and a member of the speakers bureaus of Bristol-Myers Squibb, Genentech, Pfizer, Roche, Sanofi, and Taiho.
Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 2004/12
Y1 - 2004/12
N2 - The availability of new chemotherapy agents in the last several years has had a significant impact on the treatment of colorectal cancer (CRC), but questions about how best to use these agents remain. In this article we review the evidence for maintaining full dose on schedule (FDOS) chemotherapy in CRC. To date, clinical studies have focused on determining which agents or combinations are optimal in advanced disease or the adjuvant setting. Combinations of irinotecan or oxaliplatin with 5-fluorouracil and leucovorin are currently being evaluated in the adjuvant treatment of CRC, and the addition of targeted biologic agents to standard chemotherapy regimens is being evaluated in the treatment of advanced disease. Few studies have investigated dose intensity in the adjuvant setting, and consequently, there is little evidence for a link between FDOS chemotherapy and outcomes. Nonetheless, the benefits of maintaining FDOS chemotherapy, as shown in trials in breast cancer and non-Hodgkin's lymphoma, may also hold true in CRC. Furthermore, several studies in metastatic CRC have found that greater survival can be achieved with dose-intensified chemotherapy. If FDOS chemotherapy is to become accepted in the treatment of CRC, end points other than overall survival may have to be assessed in metastatic disease and the concept will have to be investigated in the adjuvant setting. For now, the role of FDOS chemotherapy in CRC has not been adequately evaluated.
AB - The availability of new chemotherapy agents in the last several years has had a significant impact on the treatment of colorectal cancer (CRC), but questions about how best to use these agents remain. In this article we review the evidence for maintaining full dose on schedule (FDOS) chemotherapy in CRC. To date, clinical studies have focused on determining which agents or combinations are optimal in advanced disease or the adjuvant setting. Combinations of irinotecan or oxaliplatin with 5-fluorouracil and leucovorin are currently being evaluated in the adjuvant treatment of CRC, and the addition of targeted biologic agents to standard chemotherapy regimens is being evaluated in the treatment of advanced disease. Few studies have investigated dose intensity in the adjuvant setting, and consequently, there is little evidence for a link between FDOS chemotherapy and outcomes. Nonetheless, the benefits of maintaining FDOS chemotherapy, as shown in trials in breast cancer and non-Hodgkin's lymphoma, may also hold true in CRC. Furthermore, several studies in metastatic CRC have found that greater survival can be achieved with dose-intensified chemotherapy. If FDOS chemotherapy is to become accepted in the treatment of CRC, end points other than overall survival may have to be assessed in metastatic disease and the concept will have to be investigated in the adjuvant setting. For now, the role of FDOS chemotherapy in CRC has not been adequately evaluated.
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U2 - 10.1053/j.seminoncol.2004.11.023
DO - 10.1053/j.seminoncol.2004.11.023
M3 - Article
C2 - 15726534
AN - SCOPUS:11344282033
SN - 0093-7754
VL - 31
SP - 14
EP - 18
JO - Seminars in oncology
JF - Seminars in oncology
IS - SUPPL. 15
ER -