Colon and Rectal Cancers - Staging

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Highlights	Treatment	Radiation Treatment
Introduction	Surgery	Follow-up Testing
Causes	Chemotherapy	Treatment for Metastasized Colorectal Cancer
Risk Factors and Prevention	Radiation	Resources
Symptoms	Resources	References
Diagnosis and Screening	References

Irinotecan. Irinotecan (Camptosar) blocks an enzyme essential for cell division. Irinotecan can be given alone or in combination with 5-FU and leucovorin. This combination therapy (irinotecan plus 5-FU/LV) is also referred to as the "Salz regimen," or IFL. Diarrhea is a common side effect of irinotecan.

Capecitabine. Capecitabine (Xeloda), a pill form of 5-FU, is used as a treatment for stage III and stage IV (metastatic) colorectal cancer. It is the only pill approved for colorectal cancer. 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.

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Oxaliplatin. Oxaliplatin (Eloxatin) is related to cisplatin, a widely used platinum-based chemotherapy drug. Oxaliplatin is used in combination with 5-FU and leucovorin in the FOLFOX regimen. Oxaliplatin can cause pain and tingling sensations in the hands and feet (neuropathy) that is worsened by exposure to cold.

Biologic Drugs

Traditional chemotherapy drugs can be effective, but because they do not distinguish between healthy and cancerous cells their generalized toxicity can cause severe side effects. “Targeted therapies” work on a molecular level by blocking specific mechanisms associated with cancer cell growth and division.

Many targeted therapies are classified as biologic drugs. Bevacizumab (Avastin), cetixumab (Erbitux), and panitumumab (Vectibix) are currently the three biologic drugs approved for colorectal cancer treatment.

Bevacizumab. Bevacizumab (Avastin) was approved in 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 biologic anti-angiogenic drug. It 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).