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Colorectal cancer market

Nature Reviews Drug Discovery volume 3, pages 471–472 (2004)Cite this article

Oldies but goodies

Since the 1950s, the mainstay of first-line CRC chemotherapy has been 5-fluorouracil (5-FU) used either alone or, more often, in combination with leucovorin (LV, folonic acid), which improves the potency of 5-FU. Despite there being essentially only one therapy, a variety of regimens were developed that varied their dose, the manner in which they were administered (single bolus or infusion over many hours), the frequency of dosing (daily or weekly) and the duration of treatment (weeks or months). It was not until a French study by de Gramont et al. that a difference was shown between administering 5-FU as an infusion versus as an initial bolus (that is, 400 mg per m2)1. Results from this front-line study showed that the former led to statistically significant improvement in overall survival by approximately 1.2 months (that is, to 14.3 months versus 13.1 months).

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Figure 1: Estimated deaths from cancer in the United States in 2004 (%).
Figure 2: Changing regimens for colorectal cancer (CRC) treatment.

References

  1. de Gramont, A. et al. Randomized trial comparing monthly low-dose leucovorin and fluorouracil bolus with bimonthly high-dose leucovorin and fluorouracil bolus plus continuous infusion for advanced colorectal cancer: A French intergroup study. J. Clin. Oncol 15, 808–815 (1997).

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  2. Saltz, L. B. et al. Irinotecan Study Group: irinotecan plus fluorouracil and leucovorin for metastatic colorectal cancer. N. Engl. J. Med. 343, 905–914 (2000).

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  3. Goldberg, R. M. A randomized controlled trial of fluorouracil plus leucovorin, irinotecan, and oxaliplatin combinations in patients with previously untreated metastatic colorectal cancer. J. Clin. Oncol. 22, 23–30 (2004).

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  4. Hurwitz, H. et al. Bevacizumab (a monoclonal antibody to vascular endothelial growth factor) prolongs survival in first-line colorectal cancer (CRC): results of a phase III trial of bevacizumab in combination with bolus IFL (irinotecan, 5-fluorouracil, leucovorin) as first line therapy in subjects with metastatic CRC). Abstract 3646 ASCO 2003

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Authors and Affiliations

  1. biotech analysts at Schwab SoundView Capital Markets, 265 Franklin Street, Boston, 02110, Massachusetts, USA

    Richard E. T. Smith, Ronald C. Renaud & Eric Hoffman

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  1. Richard E. T. Smith
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  2. Ronald C. Renaud
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  3. Eric Hoffman
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Correspondence to Richard E. T. Smith.

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Smith, R., Renaud, R. & Hoffman, E. Colorectal cancer market. Nat Rev Drug Discov 3, 471–472 (2004). https://doi.org/10.1038/nrd1419

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