Expert review of anticancer therapy
-
Expert Rev Anticancer Ther · Apr 2008
ReviewProgress and challenges in the adjuvant treatment of stage II and III colon cancers.
Whereas the benefit of adjuvant 5-fluorouracil and leucovorin have been well established in resected stage III colon cancer, a significant benefit for patients with stage II disease has been more difficult to demonstrate. More recently, oxaliplatin-based chemotherapy with regimens such as oxaplatin plus 5-fluorouracil/leucovorin have been shown to improve disease-free and overall survival in these stage III patients. This review will discuss the development of adjuvant chemotherapy in colon cancer, focusing on recent progress and particular topical issues related to its use in this disease, such as the use of surrogate end points for overall survival in contemporary clinical trials.
-
Substantial progress has been made in understanding the pathogenesis of malignant melanoma at the cellular level, leading to the development of several new agents in the treatment of melanoma. The focus of this review is to summarize the emerging therapies and investigational agents in the treatment of melanoma over the last 5 years.
-
Expert Rev Anticancer Ther · Apr 2008
Comparative StudyRedefining adjuvant chemotherapy in patients with stage III colon cancer: X-ACT trial.
The current standard adjuvant chemotherapy for suitable patients with stage III colon cancer is the combination of oxaliplatin and 5-fluorouracil plus folinic acid (5-FU/LV). However, until recently and for many years prior to this, the accepted standard adjuvant chemotherapy was 6-8 months of bolus 5-FU/LV. However, bolus treatment was associated with significant toxicity, namely stomatitis, diarrhea and neutropenia, in addition to multiple hospital visits for drug administration for patients. ⋯ This trial demonstrated that capecitabine was at least as effective as bolus 5-FU/LV in terms of disease-free and overall survival, with trends towards superiority for both. Moreover, there was much less toxicity associated with capecitabine, apart from hand-foot syndrome which was significantly more prevalent. On the basis of the X-ACT trial, capecitabine was approved by the US FDA, the National Institute for Clinical Excellence and the Scottish Medicines Consortium as monotherapy for the adjuvant treatment of stage III colon cancer.