- Volume 7
- Issue 1 Publication Date: January 2008
Triplet Combination of Fluoropyrimidines, Oxaliplatin, and Irinotecan in the First-Line Treatment of Metastatic Colorectal Cancer
Gianluca Masi, Enrico Vasile, Fotios Loupakis, Simona Bursi, Sergio Ricci, Iacopo Petrini, Andrea Fontana, Giacomo Allegrini, Alfredo Falcone
In recent years, the treatment of metastatic colorectal cancer has improved because of the availability of 3 active cytotoxic drugs, 2 monoclonal antibodies, and the expanded use of surgery on metastases in selected patients, leading to a median overall survival of almost 2 years. Chemotherapy remains the primary option for these patients, and the development of first-line chemotherapy regimens associated with higher activity and improved efficacy is still a major topic of interest. This article provides an overview of the development of a first-line treatment combination of irinotecan and oxaliplatin plus 5-fluorouracil (5-FU; FOLFOXIRI) or oral fluoropyrimidines in patients with metastatic colorectal cancer, evaluating the feasibility and the activity of these regimens in phase I/II studies and the results of a recent phase III study that demonstrates that FOLFOXIRI significantly increases response rate, radical surgical resection of metastases, progression-free survival, and overall survival compared with an infusional 5-FU–containing doublet such as FOLFIRI (5-FU/leucovorin/irinotecan).