International Journal of Colorectal Disease

, Volume 24, Issue 6, pp 605–612

Irinotecan as palliative chemotherapy for metastatic colorectal cancer: evolving tactics following initial treatment

  • Emmanuel Mitry
  • Astrid Lièvre
  • Jean-Baptiste Bachet
  • Philippe Rougier



Patients with metastatic colorectal cancer (mCRC) who progress despite treatment with fluoropyrimidine and irinotecan or oxaliplatin have diminished survival, but they may derive clinically meaningful benefit from second-line or later chemotherapy.

Materials and methods

Literature from 2000 through mid-2008 on the treatment of patients with unresectable mCRC was reviewed to identify options for chemotherapy-resistant patients with mCRC.

Results and conclusions

A recurring finding is that overall survival increases when patients are exposed to all available active agents throughout their course of care, independent of the line of treatment in which medication is delivered. Sequential administration of agents, including irinotecan, oxaliplatin, bevacizumab, and cetuximab, or, alternatively, deferred administration of various medications in combination, have shown promising efficacy that is at least equivalent to established combination regimens with the same agents. Palliative chemotherapy clearly improves survival in patients with unresectable mCRC, with overall survival recently reaching 28 months.


Bevacizumab Capecitabine Combination treatment FOLFIRI FOLFOX Targeted agents 


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Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Emmanuel Mitry
    • 1
  • Astrid Lièvre
    • 2
  • Jean-Baptiste Bachet
    • 1
  • Philippe Rougier
    • 1
  1. 1.Hépatogastroentérologie et oncologie digestiveHôpital Ambroise ParéBoulogneFrance
  2. 2.Inserm UMR-S775, Bases moléculaires de la réponse aux xénobiotiquesUniversité Paris-DescartesParisFrance

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