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  • Irinotecan therapy and molecular targets in colorectal cancer: A systemic review

    Author(s)
    Weekes, Jessica
    Lam, Alfred
    Sebesan, Sabe
    Ho, Yik-Hong
    Griffith University Author(s)
    Lam, Alfred K.
    Year published
    2009
    Metadata
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    Abstract
    Irinotecan is the second line chemotherapy for advanced stage colorectal cancer (CRC) after failure of first line chemotherapy with oxaliplatin and 5-fluorouracil. The aim of this review is to analyse the data on irinotecan as second line chemotherapy for advanced CRC and the potential roles of the molecular markers, p53 and vascular endothelial growth factor (VEGF) in the management of advanced CRC. Thus, the English literature from 1980 to 2008 concerning irinotecan, p53, VEGF and CRC was reviewed. On review, Phase II and III clinical trials showed that irinotecan improves pain-free survival, quality of life, 1-year survival, ...
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    Irinotecan is the second line chemotherapy for advanced stage colorectal cancer (CRC) after failure of first line chemotherapy with oxaliplatin and 5-fluorouracil. The aim of this review is to analyse the data on irinotecan as second line chemotherapy for advanced CRC and the potential roles of the molecular markers, p53 and vascular endothelial growth factor (VEGF) in the management of advanced CRC. Thus, the English literature from 1980 to 2008 concerning irinotecan, p53, VEGF and CRC was reviewed. On review, Phase II and III clinical trials showed that irinotecan improves pain-free survival, quality of life, 1-year survival, progression-free survival and overall survival in advanced CRC. p53 and VEGF were expressed in CRC and had a predictive power of aggressive clinical behaviour in CRC. Irinotecan sensitizes p53 wild type, mutant and null cells to Fas-mediated cell apoptosis in CRC cells. Wild type p53 cells were more sensitive to irinotecan than mutated p53. Irinotecan has an anti-VEGF effect inhibiting endothelial cell proliferation, increasing apoptosis and reducing microvascular density which is only limited by irinotecan toxicity levels. To conclude, irinotecan improves the patient's quality of life and the survival rates of patients with advanced CRC. p53 and VEGF status of the patients' tumour is likely to affect the responsiveness of CRC to irinotecan. It is recommended that studies of the expression of these molecular markers in relation to chemo-responsiveness of irinotecan should be carried out for better management of patients with advanced CRC.
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    Journal Title
    World Journal of Gastroenterology
    Volume
    15
    Issue
    29
    Publisher URI
    http://www.wjgnet.com/1007-9327/abstract_en.asp?f=3597&v=15
    Copyright Statement
    © 2009 WJG Press. Self-archiving of the author-manuscript version is not yet supported by this publisher. Please refer to the journal link for access to the definitive, published version or contact the author[s] for more information.
    Subject
    Pathology (excl. Oral Pathology)
    Clinical Sciences
    Publication URI
    http://hdl.handle.net/10072/30181
    Collection
    • Journal articles

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