Survival of patients with advanced colorectal cancer improves with the availability of fluorouracil-leucovorin, irinotecan, and oxaliplatin in the course of treatment
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PURPOSE: Fluorouracil (FU)-leucovorin (LV), irinotecan, and oxaliplatin administered alone or in combination have proven effective in the treatment of advanced colorectal cancer (CRC). Combination protocols using FU-LV with either irinotecan or oxaliplatin are currently regarded as standard first-line therapies in this disease. However, the importance of the availability of all three active cytotoxic agents, FU-LV, irinotecan, and oxaliplatin, on overall survival (OS) has not yet been evaluated. MATERIALS AND METHODS: We analyzed data from seven recently published phase III trials in advanced CRC to correlate the percentage of patients receiving second-line therapy and the percentage of patients receiving all three agents with the reported median OS, using a weighted analysis. RESULTS: The reported median OS is significantly correlated with the percentage of patients who received all three drugs in the course of their disease (P =.0008) but not with the percentage of patients who received any second-line therapy (P =.19). In addition, the use of combination protocols as first-line therapy was associated with a significant improvement in median survival of 3.5 months (95% CI, 1.27 to 5.73 months; P =.0083). CONCLUSION: Our results support the strategy of making these three active drugs available to all patients with advanced CRC who are candidates for such therapy to maximize OS. In addition, our findings suggest that, with the availability of effective salvage options, OS should no longer be regarded as the most appropriate end point by which to assess the efficacy of a palliative first-line treatment in CRC.
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Oxaliplatin and irinotecan are both part of chemotherapy regimen for metastatic CRC.
“that are both part of chemotherapy regimen for metastatic CRC (Grothey et al., 2004).”
From Degradation of CCNK/CDK12 is a druggable vulnerability of colorectal cancer (2021) · cites this paper as Grothey et al., 2004
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- Authors
- Grothey, A., Sargent, D., Goldberg, R. M., & Schmoll, H.-J.
- Affiliations
- University of North Carolina at Chapel Hill (US)
- Venue
- Journal of Clinical Oncology
- Published
- 2004-04-01
- Volume
- 22
- Issue
- 7
- Pages
- 1209-1214
- ISSN
- 0732-183X (ISSN-L)
- 1527-7755
- OpenAlex
- W2157416388
- Cited by
- 1,070
- References
- 22
- Citations by year
- 2026: 8 · 2025: 14 · 2024: 14 · 2023: 23 · 2022: 33 · 2021: 30 · 2020: 22 · 2019: 33 · 2018: 36 · 2017: 36 · 2016: 42 · 2015: 55 · 2014: 55 · 2013: 54 · 2012: 56
- FWCI
- 37.70
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Clinical Oncology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Cancer Institute ((CA-25224, U10CA025224)
- Topics
- Health Sciences › Medicine › Oncology › Colorectal Cancer Treatments and Studies
- Health Sciences › Medicine › Oncology › Colorectal Cancer Surgical Treatments
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Cancer therapeutics and mechanisms
- Keywords
- advanced colorectal cancer, fluorouracil/leucovorin, irinotecan, oxaliplatin, combination chemotherapy, first-line therapy, second-line therapy, overall survival, drug availability, salvage therapy
- MeSH terms
- Irinotecan, Oxaliplatin, Antineoplastic Combined Chemotherapy Protocols, Camptothecin, Leucovorin, Fluorouracil, Humans, Organoplatinum Compounds, Colorectal Neoplasms, Survival Rate, Treatment Outcome, Clinical Trials, Phase III as Topic, Disease-Free Survival
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