Regimen with Irinotecan and Oxaliplatin
Irinotecan 80-100 mg IV over 90 minutes Oxaliplatin 85-125 mg IV over 30 minutes Repeat cycle every 21 days
Neutropenia, 36% Diarrhea, 24% Vomiting, 22% Paresthesia, 7%
Pitot et al, 2003
Regimens with Capecitabine and Irinotecan
Capecitabine (X) 1000 mg/m2/day by mouth days 1-14 (total dose = 2000 mg/m2/day) Irinotecan 200-250 mg IV day lu Or
Irinotecan 80 mg IV on day 1 and day 82 Repeat cycle every 21 days Capecitabine (X) 1000 mg/m2/day by mouth days 1-14 (total dose = 2000 mg/m2/day) Oxaliplatin 130 mg IV day 1 Repeat cycle every 21 days
Neutropenia, 10% Hand-foot syndrome, 6% Diarrhea, 5% Anorexia, 2%
Neutropenia, 10% Neuropathy, 6% Diarrhea
Patt et al, 2003, and Grothey et al, 2003
Diaz-Rubio et al, 2002
Abbreviations: CI, continuous infusion; IV, intravenously.
* Both irinotecan- and oxaliplatin-based regimens were active in second-line therapy, producing tumor response rates of about 10% to 15%. Hie expected approval of cetuximab will lead to use of this drug in third-line treatment of colorectal cancer. Hie expected approval of bevacizumab will add another front-line treatment for metastatic colorectal cancer.
Table 9-2. Pivotal Phase III Trials in the First-Line Treatment of Metastatic Colorectal Cancer
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