Irinotecan Fluorouracil

FOLFIRI Folinic acid (leucovorin) + 5-fluorouracil + Irinotecan given as combined IV boluses and continuous infusions... 

Rosati G, Rossi A, Germane D, Reggiardo G, Manzione L. Raltitrexed and mitomycin-C as third-line chemotherapy for colorectal cancer after combination regimens including 5-fluorouracil, irinotecan and oxaliplatin a phase II study. Anticancer Res 2003 23(3C) 2981-5. 

Note that application in the particular indications is usually restricted either to patients expressing the target (e.g. trastuzumab, cetuximab, lapatinib, imatinib) and/or after failure of prior therapies (e.g. cetuximab, erlotinib, lapatinib, sutinib, dasatinib). Furthermore, for cancer treatment most tyrosine kinase inhibitors are applied in combination with conventional chemotherapeutic drugs, such as fluorouracil, taxanes, platin-based regimens, anthracylines and irinotecan or radiotherapy. 

Hurwitz H, Fehrenbacher L, Novotny W et al (2004) Bevacizumab plus irinotecan, fluorouracil, and leucovor-in for metastatic colorectal cancer. N Engl J Med 350 2335-2342... 

Triple -drug therapy consisting of 5-fluorouracil and leucovorin with oxaliplatin or irinotecan improves survival compared with 5-fluorouracil plus leucovorin alone and is... 

FOLFIRI Irinotecan 1 80 mg/m2 IV day 1 Folinic acid (leucovorin) 200 mg/m2 IV day 1 5-Fluorouracil 400-500 mg/m2 IV bolus, after folinic acid then 2400-3000 mg/m2 of 5-fluorouracil IV over 46 hours Repeat every 14 days... 

FOLFIRI folinic acid, fluorouracil, and infusional irinotecan... 

Goldberg RM, Sargent DJ, Morton RF, et al. A randomized, controlled trial of fluorouracil plus leucovorin, irinotecan, and oxaliplatin combinations in patients with previously untreated metastatic colorectal cancer. J Clin Oncol 2004 22 23-30. 

Saltz LB, Cox JV, Blanke C et al. Irino-tecan plus fluorouracil and leucovorin for metastatic colorectal cancer. Irinotecan Study Group. N Engl J Med 2000 343 905-914. 

Irinotecan plus fluorouracil plus leucovorin Irinotecan plus infusional fluorouracil FOLFIRI6... 

Irinotecan plus bolus fluorouracil IFL Saltz regimen9... 

Irinotecan 180 mg/m2 IV plus leucovorin 400 mg/m2 IV plus bolus fluorouracil 400 mg/m2 IV, followed by fluorouracil 2,400 mg/m- continuous IV infusion over 46 hours on day I, repeated every 2 weeks Irinotecan 180 mg m2 IV day I plus leucovorin 400 m m2 then fluorouracil 400 mgftr IV, followed by... 

Chemotherapeutic agents that have significant cancer response when combined with hyperthermia (up to 43°C) include doxorubicin, melphalan, mitomycin C (MMC), mitoxantrone, gemcitabine, etoposide, and especially the platinum-based agents carboplatin and oxaliplatin (Mohamed et al., 2003 Sugarbaker et al., 2005). Agents that do not work well with hyperthermia include irinotecan, paclitaxel, docetaxel, 5-fluorouracil, and floxuridine (Mohamed et al., 2003 Sugarbaker et al., 2005). 

Cunningham, D. et al.. Randomised trial of irinotecan plus supportive care versus supportive care alone after fluorouracil failure for patients with metastatic colorectal cancer. The Lancet, 352, 1413-1418, 1998. 

Table 1 Factors Affecting 5-FU (5-fluorouracil) and CPT-11 (Irinotecan) Radiation Sensitization ...

C. Levy-Piedbois, I. Durand-Zaleski, H. Juhel, C. Schmitt, A. Bellanger, P. Piedbois, Cost-effectiveness of second-line treatment with irinotecan or infusional 5-fluorouracil in metastatic colorectal cancer, Ann. Oncol. 11 (2000) 157-161. 

Colorectal cancer (CRC) is the third most common cause of cancer-related death in women and men in the United States. The current therapeutic options for patients with metastatic CRC (mCRC) are 5-fluorouracil (5-FU) based chemotherapy regimens with the addition of irinotecan (CPT-11) or oxaliplatin. It still remains a challenge for oncologists to evaluate the reasons for a wide variation in response and toxicity among patients undergoing systemic 5-FU based chemotherapy. Pharmacogenomics... 

From Ref. (85). Abbreviations 5-FU/LV (5-fluorouracil plus leucovorin) CapeOx (capecitabine plus oxaliplatin) FOLFIRI (infusional 5-FU/LV plus irinotecan) FOLFOX (infusional 5-FU/LV plus oxaliplatin). 

Douillard JY, Cunningham D, Roth AD et al. Irinotecan combined with fluorouraeil eompared with fluorouracil alone as first-line treatment for metastatic colorectal cancer a multieentre randomised trial. Lancet 2000 355 1041-1047. 

FOLFIRI Fluorouracil, leucovorin, irinotecan FOLFOX Fluorouracil, leucovorin, oxaliplatin MP Melphalan, prednisone... 

Irinotecan is a prodrug that is converted mainly in the liver by the carboxylesterase enzyme to the SN-38 metabolite, which is 1000-fold more potent as an inhibitor of topoisomerase I than the parent compound. In contrast to topotecan, irinotecan and SN-38 are mainly eliminated in bile and feces, and dose reduction is required in the setting of liver dysfunction. Irinotecan was originally approved as second-line monotherapy in patients with metastatic colorectal cancer who had failed fluorouracil-based therapy. It is now approved as first-line therapy when used in combination with 5-FU and leucovorin. Myelosuppression and diarrhea are the two most common adverse events. There are two forms of diarrhea an early form that occurs within 24 hours after administration and is thought to be a cholinergic event effectively treated with atropine, and a late form that usually occurs 2-10 days after treatment. The late diarrhea can be severe, leading to significant electrolyte imbalance and dehydration in some cases. 

CMF Cyclophosphamide, methotrexate, fluorouracil COP Cyclophosphamide, vincristine (oncovin), prednisone FAC Fluorouracil, doxorubicin (adriamycin), cyclophosphamide FEC Fluorouracil, epirubicin, cyclophosphamide IFL Irinotecan, fluorouracil, leucovorin MP Melphalan, prednisone... 

Oxaliplatin is a third generation diaminocyclohexane platinum analog. Its mechanism of action is identical to that of cisplatin and carboplatin. However, it is not cross-resistant to cancer cells that are resistant to cisplatin or carboplatin on the basis of mismatch repair defects. This agent was recently approved for use as second-line therapy in metastatic colorectal cancer following treatment with the combination of fluorouracil-leucovorin and irinotecan, and it is now widely used as first-line therapy of this disease as well. Neurotoxicity is dose-limiting and characterized by a peripheral sensory neuropathy, often triggered or worsened upon exposure to cold. While this neurotoxicity is cumulative, it tends to be reversible—in contrast to cisplatin-induced neurotoxicity. 

Carcinoma of colon Fluorouracil plus leucovorin plus irinotecan Oxaliplatin... 

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