New Chemotherapeutic Advances in Pancreatic, Colorectal, and Gastric Cancers

Abstract

Pancreatic, gastric, and colorectal cancers are major causes of morbidity and mortality worldwide. When curative surgical resection is not an option, these malignancies tend to respond very poorly to chemotherapy and carry a dismal prognosis. There is, therefore, an urgent need for novel treatment strategies for these cancers. Great strides have been made in colon cancer treatment with the recent introduction of several novel agents, including capecitabine, irinotecan, and oxaliplatin either alone or in combination regimens. Treatment of advanced colon cancer, however, remains essentially palliative, and treatmentrelated toxicity remains a significant problem. The treatment of advanced gastric and pancreatic cancer has also seen the introduction of new agents, such as gemcitabine and irinotecan; however, the impact of these agents on survival has been small, and toxicity continues to be a major obstacle. The search for new chemotherapeutic agents and treatment strategies will need to focus on improving outcomes and safety and tolerability profiles. To date, several new agents have shown promise, including pemetrexed, G17DT, bevacizumab, and other targeted agents. Further research into their optimal use either alone or in combination regimens should be a priority.

Randomised phase II evaluation of irinotecan plus high-dose 5-fluorouracil and leucovorin (ILF) vs 5-fluorouracil, leucovorin, and etoposide (ELF) in untreated metastatic gastric cancer

“…Although chemotherapy regimens offer at best a slight, albeit statistically significant, improvement in survival for patients with gastric cancer, they are associated with a degree of toxicity that limits their value as a palliative treatment (Vanhoefer et al, 2000;Schoffski, 2002;Diaz-Rubio, 2004).…”

Irinotecan, leucovorin and 5-fluorouracil (modified FOLFIRI) as salvage chemotherapy for frail or elderly patients with advanced gastric cancer

“…A variety of FOLFIRI regimens have been examined in the clinical setting (9-11); however, in this study we used the modified FOLFIRI regimen (biweekly irinotecan 150 mg/m 2 with LV 100 mg/m 2 and 5-FU 2,000 mg/m 2 ) for patients with AGC. We adopted an infusional 5-FU regimen due to low hematological toxicity levels observed compared to bolus 5-FU (12).…”

Anti-Cancer Effect of the Combination of Thiacremonone and Docetaxel by Inactivation of NF-κB in Human Cancer Cells

“…Docetaxel, a semi-synthetic member of the taxane family, has potential activity against human solid tumors including prostate cancers (Diaz-Rubio, 2004). However, the use of high-dose docetaxel induced significant toxicity (Tedesco et al, 2004;Sun et al, 2007), but low or moderate doses of docetaxel have no significant anti-cancer activity in patients (Ryan et al, 2002).…”

“…Docetaxel, a semisynthetic taxoid produced from the needles of the European yew (Taxus baccata) tree, is one of the most important active chemotherapeutic agents for human prostate cancers (Diaz-Rubio, 2004). However, the use of high-dose docetaxel induce significant toxicities such as asthenia, neuropathy, vertigo and tinnitus (Sarafraz and Ahmadi, 2008;Baker et al, 2009), whereas lowdose of docetaxel have no significant antitumor activity in patients (Ryan et al, 2002).…”