Clinical Activity and Benefit of Irinotecan ( CPT-11) in Patients with Metastatic Colorectal Carcinoma Pre- treated with Fluorouracil-Based Chemotherapy

VORACHAI RATANATHARATHORN, M.D.*, EKAPOB SIRACHAINAN, M.D.*, MANMANA JIRAJARUS, R.N., M.S.N.**, SUWANNEE SIRILERTTRAKUL, R.N., M.Ed.**

Affiliation : * Department of Medicine, ** Department of Nursing, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok. 10400. Thailand.

AbstractThe purpose of this prospective study was to assess the efficacy, clinical benefit and safety of irinotecan (CPT -11) in patients with 5-fluorouracil-resistant metastatic colorectal cancer (CRC). Sixteen patients with World Health Organization (WHO) performance status s: 2 were treated with CPT-11 350 mg/m2 every 3 weeks. The observed partial response (PR) rate was 6.3 per cent with a high rate of stable disease (SD) ( 43.7%) which was of long duration (21.1 weeks for the best response ; 1PR, 7SD). The median survival time for the 16 patients entered into this study was 69.6 weeks. There was no toxic death. The most frequent adverse events were neutro- penia (31% grade 3/4) and delayed diarrhea (9.7%). CPT-II has definite activity in the treatment of progressive metastatic CRC truly resistant to 5-FU which translated into clinical survival benefit. Median survival from first administration of CPT-II was 78.6 weeks for patients with best response (PR+SD) compared with 28.1 weeks for patients with progressive disease (PD) (P=O.Ol). With the appearance of new active drugs in this highly chemotherapy-resistant disease. the definition of response should be reassessed in CRC.

Keywords : Advanced Colorectal Cancer (CRC), Irinotecan

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