Gan to kagaku ryoho. Cancer & chemotherapy
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Gan To Kagaku Ryoho · Jul 2000
Review[CPT-11 (irinotecan)--evidence from molecular and pharmacological studies and clinical applications].
Irinotecan (CPT-11) is a derivative of the chemotherapeutic agent Camptothecin. CPT-11 inhibits the nuclear enzyme topoisomerase I. It has demonstrated a broad spectrum of antitumor activity in preclinical tumor model systems. ⋯ CPT-11 has demonstrated significant clinical activity in the treatment of patients with gastrointestinal, pulmonary, gynecologic, and lymphoid malignancies. A recent randomized trial demonstrated a survival advantage in metastatic non-small cell lung cancer and previously untreated metastatic colorectal cancer. Further study of this agent to determine its role in combination chemotherapeutic regimens is currently underway.
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To facilitate the proper and quick evaluation of cancer chemotherapy, the issues of surrogate and true endpoints in clinical trials were reviewed. Surrogate endpoints are defined as response variables that can substitute for a true endpoint due to their close correlation with the true endpoint, and their occurrence earlier than true endpoint. The response rate in cancer chemotherapy has been used as a surrogate or true endpoint for the evaluation of treatments. However, recent studies revealed that response rates do not always correlate with survival time (time to failure), and better surrogate endpoints such as time to progression, median survival time, or various surrogate biomarkers are now under investigation.