Oxaliplatin plus oral fluoropyrimidines in colorectal cancer.
Oxaliplatin plus oral fluoropyrimidines in colorectal cancer.
复制标题
DOI：
10.3816/ccc.2004.s.006
复制
发表时间：
2004-06-01
影响因子：
3.4
通讯作者：
Goetz, Matthew P
中科院分区：
文献类型：
--
作者：
Grothey, Axel;Goetz, Matthew P
近年来，随着伊立替康、奥沙利铂和卡培他滨等新型细胞毒性药物的引入，结直肠癌（CRC）的药物治疗迅速发展。使用输注5-氟尿嘧啶（5-FU）/亚叶酸（LV）加奥沙利铂或伊立替康的联合方案已证明在晚期CRC中具有临床意义和高疗效。根据组间试验N9741的结果，FOLFOX 4（输注加推注5-FU/LV和奥沙利铂的联合治疗）已成为姑息治疗环境中的标准一线治疗。然而，基于5-FU的输注方案需要使用中心静脉管线和可植入端口以允许在门诊基础上进行治疗，因此不方便且昂贵。口服氟尿嘧啶（卡培他滨或尿嘧啶/替加氟[UFT]+ LV）作为输注5-FU与奥沙利铂联合方案的替代品提供了更大的便利性，同时可以想象维持了静脉方案观察到的高疗效和耐受性。最近报告了各种I/II期试验，研究奥沙利铂联合卡培他滨或UFT/LV治疗晚期CRC患者。本综述将详细介绍这些试验的结果，重点是基于卡培他滨的组合。
The medical treatment of colorectal cancer (CRC) has rapidly evolved in recent years with the introduction of novel cytotoxic drugs into clinical practice such as irinotecan, oxaliplatin, and capecitabine. Combination regimens using infusional 5-fluorouracil (5-FU)/leucovorin (LV) plus either oxaliplatin or irinotecan have demonstrated clinically meaningful, high efficacy in advanced CRC. Based on the results of the Intergroup trial N9741, FOLFOX4, a combination of infusional plus bolus 5-FU/LV and oxaliplatin, has emerged as the standard first-line therapy in the palliative setting. However, infusional 5-FU-based regimens carry the need for use of central venous lines and implantable ports to allow treatment on an outpatient basis and are thus inconvenient and expensive. The use of oral fluoropyrimidines (capecitabine or uracil/tegafur [UFT] plus LV) as substitutes for infusional 5-FU in combination protocols with oxaliplatin offers greater convenience, at the same time conceivably maintaining the high efficacy and tolerability observed with intravenous protocols. Various phase I/II trials have recently been reported that investigated oxaliplatin in combination with either capecitabine or UFT/LV in patients with advanced CRC. This review will detail the results of these trials focused on capecitabine-based combinations.