EUROPEAN EXPERIENCE WITH IRINOTECAN PLUS FLUOROURACIL FOLINIC ACID ORMITOMYCIN

Tremendous progress has been made in the medical treatment of advanced colorectal cancer during the past 2 to 3 years, due to the availabili ty of several new drugs. Of these new agents, irinotecan (CPT-11 [Camp tosar]) seems to be one of the most active against advanced colorectal cancer. It is, therefore, a good candidate for combination with the m ore classic cytotoxic agents for this disease. This article summarizes several European phase I and II studies in which irinotecan has been combined with (1) fluorouracil (5-FU) alone, given as a repeated bolus injection or a protracted infusion; (2) 5-FU modulated by folinic aci d (leucovorin) according to different schedules; or (3) mitomycin (Mut amycin). All of these studies have demonstrated clinical responses in patients with advanced colorectal carcinoma, including complete respon ses. The toxicity profiles of the various combinations seem to be acce ptable; neutropenia and delayed diarrhea are the most frequency side e ffects. Large phase III studies are still warranted to demonstrate the benefit of these irinotecan-based regimens.