New chemotherapy approaches in colorectal cancer

Colorectal cancer is one of the leading causes of cancer deaths in the West ern world, with approximately 50% of all patients dying from metastatic dis ease. Until recently, therapeutic options for advanced colorectal cancer we re mainly confined to chemotherapy with 5-fluorouracil in various schedules , with or without biochemical modulation with leucovorin. The development o f new cytotoxic drugs with substantial activity in this tumor during the pa st 2 years has dramatically changed treatment strategies and therapeutic go als in metastatic colorectal cancer and has introduced neoadjuvent chemothe rapy followed by secondary surgery with the intent of long-term survival. A mong these new drugs, oral fluoropyrimidines (tegafur/uracil and capecitabi ne), irinotecan, and oxaliplatin have already established themselves as par t of various treatment approaches. Other novel therapeutics including agent s designed to act on molecular targets already show promising activity and will become part of combination protocols with current standard chemotherap y. (C) 2001 Lippincott Williams & Wilkins, Inc.