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Abstract
Modern chemotherapy combinations for metastatic colorectal cancer (mCRC) comprise
infusional 5-fluorouracil (5-FU), leucovorin, and irinotecan or oxaliplatin. The fluoropyrimidine
derivative capecitabine is at least as effective as 5-FU plus leucovorin bolus regimens.
It displays a favorable toxicity profile and offers the advantages of oral administration.
The epidermal growth factor receptor antibody cetuximab induces synergistic antitumor
activity when combined with chemotherapy. In pretreated patients, cetuximab can restore
the sensitivity to irinotecan and, therefore, has been registered in this setting.
Several phase I/II trials have investigated the combination of cetuximab with irinotecan-based
or oxaliplatin-based chemotherapy for the first-line treatment of mCRC. These combinations
have been proven to be safe and have provided promising efficacy data. A recent phase
III trial confirmed improved progression-free survival, response rates, and a particularly
significant increase of secondary resection rates for the combination of FOLFIRI (infusional
5-FU/leucovorin/irinotecan) plus cetuximab compared with FOLFIRI alone. In this review,
we discuss the background of combining XELIRI (capecitabine/irinotecan) or XELOX (capecit-abine/oxaliplatin)
with cetuximab for the first-line treatment of mCRC and present available data of
these combined cytotoxic and targeted treatment approaches.
Key words
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Article info
Publication history
Accepted:
December 7,
2007
Received in revised form:
December 7,
2007
Received:
June 27,
2007
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© 2008 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
