Chemotherapy

5 Florouracyl – weekly or every 21 days? – pro

Fluoropyrimidine (5-fluorouracil [5-FU] is the oldest chemotherapy drug for colon cancer and it is usually given with leucovorin [LV]. For second or third line therapy, single agents are acceptable  and NCCN has a complex schema when to give what for second line and also lists Erbitux and Vectbix. Capecitabine is also FDA approved as a single agent. NCCN does not list 5FU/Leukovorin but it can also be considered appropriate given the long history

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Gemzar alone for colorectal cancer – pro

The role of gemcitabine for colorectal can has not been defined. Moore et al found that Gemcitabine, at the doses and schedule used in his study, did not demonstrate activity against advanced colorectal adenocarcinoma. A much later study from Columbia University(Saif et al) found that Gemcitabine has a modest activity in heavily pre-treated colorectal cancer patients and may be an option in good performance status patients. There are a number of

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Sprycel for colon cancer – pro

Dasatinib, also known as Sprycel, is a cancer drug produced by Bristol-Myers Squibb and sold under the trade name Sprycel. It is a drug that is approved by the FDA for chronic myelogenous leukemia. It has an effect on the Src kinases, which interact with the EGFR receptor. One phase II trial(Nautiyal et al) showed that Dasatinib is inactive in previously treated metastatic colorectal patients patients. There is a trial that is studying this drug:

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Xeliri second line for metastatic colorectal cancer – pro

The issue that we will discuss is Xeliri (Xeloda and irinotecan) in second or later line of therapy. It is a tempting regimen because Xeldoa is an generally effective drug for colorectal cancer and it is oral.  We start by pointing out that there are now six different classes of drugs with significant antitumor activity in colon cancer: Fluoropyrimidine (5-fluorouracil [5-FU] which is usually given with leucovorin [LV], capecitabine, tegafur plus

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Folfox and Folfiri for metastatic colorectal cancer – pro

Currently, there are seven active and approved chemotherapy drugs for patients with metastatic colorectal cancer: 5-FU, capecitabine, irinotecan, oxaliplatin, bevacizumab, cetuximab, and panitumumab. Among the best studied ways of putting some of these drugs together are the regimen Folfox and Folfiri. Three randomized studies demonstrated improved response rates, progression-free survival (PFS), and OS when irinotecan or oxaliplatin was combined

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Intrahepatic chemotherapy for colon cancer metastases – pro

The potential value of hepatic intra-arterial chemotherapy (HIAC) can be considered from several different perspectives. A fundamental assumption for this discourse requires that, in this evaluation, HIAC is being provided with the intent of providing regional hepatic therapy for metastatic hepatic disease. Despite advances in colon cancer (CRC) screening, surgical techniques, and several novel adjuvant agents, CRC continues to be a significant medical

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New drug: Zaltrap – pro

Zaltrap was approved by the FDA in the beginning of August 2012 for patients who fail oxaliplatin. It is also known as aflibercept, VEGF trap or, when used for macular degeneration, Eylea. It is a recombinant fusion protein between the Fc portion of human IgG1 and the extracellular domains of VEGF receptor 1 & 2 (VEGFR 1 & VEGFR 2), which binds VEGF-A and VEGF-B (vascular endothelial growth factor), as well as PLGF (placental growth factor).

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Chemo Options for Later Lines of Therapy for Metastatic Colon Cancer – pro

There are now five different classes of drugs with significant antitumor activity in colon cancer: Fluoropyrimidine (5-fluorouracil [5-FU] which is usually given with leucovorin [LV], capecitabine, tegafur plus uracil [UFT]). Irinotecan, Oxaliplatin, Cetuximab and panitumumab. The latter two are monoclonal antibodies (MoAbs) directed against the epidermal growth factor receptor (EGFR), and bevacizumab, is a monoclonal antibody targeting vascular

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