Intensified irinotecan-based neoadjuvant chemoradiotherapy in rectal cancer: Four consecutive designed studies to minimize acute toxicity and to optimize efficacy measured by pathologic complete response

Klautke, Günther; Küchenmeister, Ute; Foitzik, Thomas; Ludwig, Kaja; Semrau, Sabine; Prall, Friedrich; Klar, E.; Fietkau, Rainer

doi:10.1016/j.radonc.2007.10.042

Cited by 23 publications

(14 citation statements)

References 14 publications

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“…This negative patient selection might also explain the relatively high rate of local recurrences (17% cumulative risk of local recurrence after 5 years). Future trials are necessary to evaluate the efficacy of other drugs or multiple drug combinations [15,17,18,[26][27][28]. Moreover, a possible impact of timing of daily capecitabine administration and radiation should be further investigated [39].…”

Section: On the Basis Of The German Rectalmentioning

confidence: 99%

Neoadjuvant Capecitabine Combined with Standard Radiotherapy in Patients with Locally Advanced Rectal Cancer

et al. 2008

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Section: On the Basis Of The German Rectalmentioning

confidence: 99%

Neoadjuvant Capecitabine Combined with Standard Radiotherapy in Patients with Locally Advanced Rectal Cancer

et al. 2008

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“…Двое паци-ентов, участвовавших в исследовании, погибли, что за-ставило авторов провести «работу над ошибками», и в 2007 г. вышла публикация, суммировавшая опыт назначения иринотекана с фторпиримидинами в 4 ис-следованиях II фазы. Авторам удалось добиться при-емлемого профиля токсичности и высокой частоты полных ответов в исследовании, где пациенты получа-ли лечение в режиме иринотекан 60 мг/м 2 1 раз в не-делю и капецитабин 1500 мг/м 2 в дни 1-14-й и 22-35-й (частота полного морфологического ответа в этом исследовании достигла 35 %) [61].…”

Section: иринотекан в неоадъювантной терапииunclassified

Irinotecan in the treatment of colorectal cancer. A literature review

Иванов¹,

Гордеев²,

Байчоров³

et al. 2017

Onkol. koloproktol.

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“…Large randomized trials have demonstrated its activity against metastatic colorectal cancer as a single agent or in combination with 5‐FU and leucovorin 38‐40. Multiple phase 1 and 2 studies have investigated combinations of irinotecan with fluoropyrimidine‐based chemoradiation, with pCR rates ranging from 0% to 38% 24, 26, 41‐43. In what to our knowledge is the largest of these studies, Navarro et al reported results from a phase 2 trial in which 74 patients with resectable T3/4 rectal cancer were treated with 50 mg/m 2 of irinotecan weekly in combination with 5‐FU–based chemoradiotherapy (225 mg/m 2 administered 5 days perweek) 43.…”

Section: Irinotecanmentioning

confidence: 99%

The role of targeted agents in preoperative chemoradiation for rectal cancer

Wadlow

Ryan

2010

Cancer

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In the United States, randomized trials have established preoperative chemoradiation as the standard of care for patients with locally advanced rectal cancer. Pathologic complete response (pCR) rates occur in 10% to 16% of patients and have been shown to be correlated with both disease-free and overall survival. Therefore, recent efforts incorporating newer cytotoxic and molecularly targeted agents into chemoradiotherapy regimens have reported the pCR rate to be a surrogate marker of clinical outcomes. Substitution of oral fluoropyrimidines, including capecitabine, for infusional 5-fluorouracil reportedly generated pCR rates of up to 32% in phase 2 studies, but definitive evaluation awaits results from the National Surgical Adjuvant Breast and Bowel Project (NSABP) R-04 trial. Similarly, regimens incorporating irinotecan generated pCR rates as high as 38%, but to the authors' knowledge have not been evaluated in randomized trials. In contrast, 2 large randomized trials reported that the addition of weekly oxaliplatin to fluoropyrimidine-based chemoradiation led to an increase in grade 3/4 toxicity but no difference in pCR rates. Early phase trials evaluating the anti-epidermal growth factor receptor (EGFR) antibody cetuximab in combination with chemoradiation reported modest pCR rates of 5% to 12%, and efforts have focused on identifying biomarkers of response including EGFR copy number, k-ras mutational status, and both serum and tumor-specific expression of EGFR ligands. Finally, incorporation of the anti-vascular endothelial growth factor antibody bevacizumab into chemoradiation appears to be safe and feasible, with initial studies reporting a beneficial effect on vascular normalization and correlations between circulating biomarkers of angiogenesis and pathologic response. Future efforts should include prospective studies of these agents in biomarker-defined subpopulations, as well as studies of novel agents that target angiogenesis, tumor-stromal interaction, and the cell signaling pathways implicated in colorectal cancer. Cancer 2010;116;3537-48.

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Intensified irinotecan-based neoadjuvant chemoradiotherapy in rectal cancer: Four consecutive designed studies to minimize acute toxicity and to optimize efficacy measured by pathologic complete response

Cited by 23 publications

References 14 publications

Neoadjuvant Capecitabine Combined with Standard Radiotherapy in Patients with Locally Advanced Rectal Cancer

Neoadjuvant Capecitabine Combined with Standard Radiotherapy in Patients with Locally Advanced Rectal Cancer

Irinotecan in the treatment of colorectal cancer. A literature review

The role of targeted agents in preoperative chemoradiation for rectal cancer

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