Colon and Rectal Cancers - Medications

Raltitrexed. Raltitrexed (Tomudex) may be effective and may have additive or synergistic effects with 5-FU.

RecentlyApproved Treatments

Bevacizumab. Bevacizumab (Avastin) was approved in February 2004 as a first-line treatment for patients with metastatic colorectal cancer (advanced cancer that has spread in the body). It is used in combination with IFL (irinotecan, 5-FU, leucovorin). Bevacizumab is a genetically engineered monoclonal antibody that targets and inhibits vascular endothelial growth factor (VEGF), a protein that regulates angiogenesis (the development of new blood vessels that feed a tumor's blood supply). It is the first anti-angiogenic therapy approved for the treatment of colorectal cancer. In a study of 800 patients with metastatic colorectal cancer, bevacizumab administered intravenously along with IFL extended survival by approximately 5 months longer than IFL alone. Common side effects of bevacizumab are nosebleeds, fatigue, diarrhea, and high blood pressure. Less common side effects include stroke, heart attacks, angina, and formation of holes in the colon and stomach (gastrointestinal perforation).

Cetuximab. Cetuximab (Erbitux) was approved in February 2004 for the treatment of metastatic colorectal cancer. This monoclonal antibody drug targets epidermal growth factor receptor (EGFR), a protein required by cancer cells in order to proliferate. It can be used either in combination with irinotecan, or alone for patients who have not responded to irinotecan. Clinical research demonstrated that combination treatment delayed tumor growth by 4 months. For patients who received only cetuximab, tumor growth was delayed by 1.5 months.

Oxaliplatin. Oxaliplatin (Eloxatin) received a new indication approval in January 2004 as a first-line treatment for advanced colorectal cancer. The drug is used in combination with 5-FU and leucovorin (LV). In data submitted for the approval process, patients who received oxaliplatin in combination with 5-FU and LV survived an average of nearly 5 months longer than patients who received only 5-FU and LV.

Side Effects of Chemotherapy

Side effects occur with all chemotherapeutic drugs; they are more severe with higher doses and increase over the course of treatment. Because cancer cells grow and divide rapidly, anticancer drugs work by killing fast-growing cells. This means that healthy cells that multiply quickly can also be affected. The fast-growing normal cells most likely to be affected are blood cells forming in the bone marrow, and cells in the digestive tract, reproductive system, and hair follicles.