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Back To Vidyya The Present And Future Of Cancer Therapy:

Versatile Anti-Cancer Drug Irinotecan

"The Oncologist" -- a bi-monthly international peer-reviewed journal for physicians devoted to cancer patient care -- reports on an important new anti-cancer drug, irinotecan (CPT-11; Camptosar®; Pharmacia Inc.), in its latest issue (Vol. 6, No. 1, 2001).

Irinotecan, approved for first-line therapy in patients with metastatic colorectal cancer, has been shown to increase progression-free survival, delay tumor growth and also is showing potential in other cancer types.

The "Promising New Drugs and Combinations" section of the journal features a commentary by Dr. Leonard B. Saltz of Memorial Sloan-Kettering Cancer Center, as well as two research studies by Saltz and colleagues on the drug's use in treating colorectal cancer, and a five-year review by Dr. Mace L. Rothenberg of Vanderbilt-Ingram Cancer Center, of irinotecan's recent treatment of other cancers.

In his commentary, "Irinotecan: A New Agent Comes of Age," Dr. Saltz discusses how "in some respects the development of irinotecan served as a new model for anticancer drug development," leading an international effort to define and develop the drug as a treatment for colorectal cancer that was resistant to the then-standard of care, fluorouracil (5-FU). This was the first time a drug development strategy was focused on previously treated patients who did not respond to chemotherapy, rather than on newly diagnosed patients.

In "Irinotecan Plus Fluorouracil/Leucovorin for Metastatic Colorectal Cancer: A New Survival Standard," Dr. Saltz and colleagues report on two prospective, phase-III randomized, controlled, multi-center, multinational clinical trials for patients with previously untreated metastatic colorectal cancer. In separate studies, the combination of irinotecan with 5-FU/leucovorin extended survival time by 20 percent. It also showed a 50 percent overall tumor response rate and garnered a 50 percent increase in median time to tumor progression, relative to treatment with 5-FU/leucovroin alone for patients with advanced colorectal cancer. These results served as the basis for the regimen's approval as first-line therapy for metastatic colorectal cancer in the United States and Europe.

In "Irinotecan (CPT-11): Recent Developments and Future Directions; Colorectal Cancer and Beyond," Dr. Rothenberg discusses phase II and III studies suggesting "that irinotecan may have an important role in the treatment of a number of other cancers, including small cell lung cancer and non-small cell lung cancer, esophageal cancer, gastric cancer, cervical cancer, malignant brain tumors and ovarian cancer," as well as pancreatic cancer. He also notes that irinotecan may be more useful as a molecularly targeted compound and sees future research focusing on better drug combinations with irinotecan and using it in combination with radiation.

Clearly, irinotecan (CPT-11) represents a major new drug in the treatment of aggressively growing tumors.

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Editor: Susan K. Boyer, RN
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