Adding irinotecan to a standard treatment regimen for metastatic colorectal
cancer increases overall survival rates and lengthens the time to progression,
according to researchers from the United States and Canada.
Dr Leonard Saltz (Memorial Sloan-Kettering Cancer Centre, New York) and colleagues,
reporting on behalf of the Irinotecan Study Group, randomly assigned 667 patients
into three groups. One group received fluorouracil, irinotecan (Campto) and
calcium folinate, the second group received fluorouracil and calcium folinate
and the third irinotecan on its own.
They found that treatment with the combination of all three drugs resulted in
increased overall survival and time to progression of the disease compared with
either the fluorouracil/calcium folinate combination or irinotecan alone. Median
progression-free survival was 7.0 months in the triple therapy group, 4.3 months
in the standard therapy group and 4.2 months in the irinotecan-only group. The
median overall survival rates were 14.8 months, 12.6 months and 12.0 months,
respectively.
Patients receiving either triple therapy or irinotecan only were given the drugs
weekly for four weeks every six weeks, while those receiving fluorouracil and
calcium folinate were given the drugs daily for five days every four weeks (New
England Journal of Medicine 2000;343:905).
The authors say that their findings support those of a European study (see PJ,
April 8, p533) published
earlier this year, whose authors recommended that the triple-therapy be considered
as first-line for metastatic colorectal cancer.