ABSTRACT
In the last decade, the value of first-line treatment for patients with advanced colorectal cancer has been demonstrated and widely accepted. Response rates of 20-30%, a median survival of 12-14 months, and a quality-of-life benefit compared with best supportive care have been demonstrated with 5-fluorouracil (5-FU) and folinic acid (FA, leucovorin). The oral fluoropyrimidines capecitabine and UFT (uracil plus tegafur), and the specific thymidylate synthase inhibitor raltitrexed, are also active drugs in the treatment of advanced colorectal cancer.1,2 Recently, it has been shown that combination treatment with 5-FU/FA/irinotecan and with 5-FU/FA/oxaliplatin induces significantly higher response rates (40-50%) and a longer time to tumour progression (TTP) or progression-free survival (PFS) compared with 5-FU/FA. The median survival is significantly prolonged for the combination 5-FU/FA/irinotecan compared with 5-FU/FA.3-5 These new data influence the approach to patients with metastatic colorectal cancer.
