Irinotecan and radiosensitization in rectal cancer.

Abstract

Neoadjuvant radiation therapy with concurrent 5-fluorouracil-based chemotherapy is currently considered the standard of care for locally advanced rectal cancer. Pathologically complete response is a desirable outcome and has been associated with increased disease-free survival. There is a need to improve on this approach given that only approximately 10% achieve a pathologically complete response. Irinotecan has an established role in the treatment of metastatic rectal cancer. Both in-vitro and in-vivo data have shown promising radiosensitization properties. This study provides an overview of the published clinical trials evaluating the role of irinotecan as a radiosensitizer in the management of locally advanced rectal cancer. Although early-phase clinical trials initially showed promising results, this did not translate into improved outcome in a larger randomized phase II trial. Increased topoisomerase I expression has recently been identified as a possible predictive marker for improved response to irinotecan-based radiosensitization. This finding could help identify a subset of patients more likely to benefit from the addition of irinotecan in future trials.

• Authors: Henrik Illum
• Journal: Anti-cancer drugs (Anticancer Drugs) Vol. 22 Issue 4 Pg. 324-9 (Apr 2011) ISSN: 1473-5741 [Electronic] England
• PMID: 21160419 (Publication Type: Journal Article, Review)

Chemical References

• Antineoplastic Agents, Phytogenic
• Radiation-Sensitizing Agents
• Irinotecan
• DNA Topoisomerases, Type I
• Camptothecin

Topics

• Antineoplastic Agents, Phytogenic (therapeutic use)
• Camptothecin (analogs & derivatives, therapeutic use)
• DNA Topoisomerases, Type I (genetics)
• Humans
• Irinotecan
• Meta-Analysis as Topic
• Neoadjuvant Therapy
• Radiation-Sensitizing Agents (therapeutic use)
• Rectal Neoplasms (drug therapy, enzymology, genetics, radiotherapy)