Colorectal cancer (CRC) is one the greatest contributors to cancer related mortality.
Although 5 year survival rate for patients at the early stage of CRC (stages I and II) is above
60%, more than 50% of patients are diagnosed at or beyond stage III when distant metastasis
has already occurred, in which case 5 year survival rate drops to 10%. Chemotherapeutic intervention
coupled with surgery is the backbone of metastatic CRC treatment and the only
means of enhanced survival. For decades following its discovery, an antimetabolite 5-
fluorouracil (5-FU) was the only chemotherapeutic agent available to successfully improve 12
month survival in CRC patients. Treatment of metastatic CRC has been considered palliative
for many years; aiming to increase the duration and quality of the patient's remaining life, with
little hope of cure, highlighting the need for novel DNA and RNA targeted therapies in the
treatment of CRC. Over the last several decades, combinations of several chemotherapeutic
agents have been incorporated into routine clinical practice. Combination regimes incorporating
irinotecan, a semisynthetic inhibitor of topoisomerase, oxaliplatin, a third-generation platinum
compound that causes mitotic arrest via the formation of DNA adducts, and capecitabine,
a 5-FU prodrug, are now all established options for use as first-line, second-line and sequential
treatment of CRC. This review provides a brief overview of the evolution of CRC chemotherapy
as well as new and emerging treatment options.
Keywords: Colorectal cancer, chemotherapy, 5-fluorouracil, capecitabine and leucovorin, cisplatin and oxaliplatin,
combination chemotherapy, targeted therapies and anti-inflammatories, ruthenium, PARP inhibitors.
Rights & PermissionsPrintExport