Medical Health Encyclopedia

Capecitabine. Capecitabine (Xeloda) is the first pill approved for metastatic colorectal cancer. A major 2005 study, published in the New England Journal of Medicine, found that capecitabine worked as well as the standard 5-FU/leucovrin treatment and caused significantly fewer side effects. The study involved patients with stage III colon cancer who had undergone surgical removal of the tumor. Capecitabine is also showing promise in combination with radiation therapy for rectal cancers.

Oxaliplatin. Oxaliplatin (Eloxatin) is related to cisplatin, a widely used platinum-based chemotherapy drug. Oxaliplatin is used in combination with 5-FU and leucovorin. (This triple combination therapy is called the FOLFOX regimen.) Oxaliplatin was approved in 2002 for use in combination with 5-FU and leucovorin as a second-line treatment for cancer that has progressed after initial therapy. Since 2002, oxaliplatin has received additional approvals as a first-line treatment for advanced colorectal cancer, and as a post-surgical treatment for patients who have undergone tumor resection. Oxaliplatin can cause pain and tingling sensations in the hands and feet (neuropathy) that is worsened by exposure to cold.

Raltitrexed. Raltitrexed (Tomudex) may be effective and may have additive or synergistic effects with 5-FU.

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Recently Approved Treatments

Bevacizumab. Bevacizumab (Avastin) was approved in February 2004 as a first-line treatment for patients with metastatic colorectal cancer (advanced cancer that has spread in the body). It is used in combination with IFL (irinotecan, 5-FU, leucovorin). Bevacizumab is a genetically engineered monoclonal antibody that targets and inhibits vascular endothelial growth factor (VEGF), a protein that regulates angiogenesis (the development of new blood vessels that feed a tumor's blood supply). It is the first anti-angiogenic therapy approved for the treatment of colorectal cancer. In a study of 800 patients with metastatic colorectal cancer, bevacizumab administered intravenously along with IFL extended survival by approximately 5 months longer than IFL alone. Common side effects of bevacizumab are nosebleeds, fatigue, diarrhea, and high blood pressure. Less common side effects include stroke, heart attacks, angina, and formation of holes in the colon and stomach (gastrointestinal perforation).