Authors' objectives:

To provide guidance on the use of irinotecan, oxaliplatin and raltitrexed for the treatment of advanced colorectal cancer.

Authors' recommendations: Guidance 1.1 On the balance of clinical and cost-effectiveness, neither irinotecan nor oxaliplatin in combination with 5-fluorouracil and folinic acid (5FU/FA) are recommended for routine first-line therapy for advanced colorectal cancer. 1.2 Oxaliplatin should be considered for use as first-line therapy, in combination with 5FU/FA, in advanced colorectal cancer in patients with metastases that are confined solely to the liver and may become resectable ('down staged') following treatment. 1.3 Irinotecan monotherapy is recommended in patients who have failed an established 5-fluorouracil containing treatment regimen. 1.4 On the balance of evidence relating to its clinical and cost effectiveness, raltitrexed is not recommended for the treatment of advanced colorectal cancer. Its use for this patient group should be confined to appropriately designed clinical studies. 1.5 It is likely that patients currently receiving irinotecan or oxaliplatin in combination with 5FU/FA or raltitrexed could suffer loss of well being if their treatment is discontinued at a time they did not anticipate. Because of this, patients and their consultants may wish to continue therapy until they consider it is appropriate to stop.

Authors' methods: Systematic review

Project Status: Completed

URL for project: http://www.nice.org.uk/cat.asp?c=28734

Year Published: 2002

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: England, United Kingdom

Organisation Name: National Institute for Clinical Excellence

Contact Address: MidCity Place, 71 High Holborn, London WC1V 6NA, UK. Tel: +44 020 7067 5800; Fax: +44 020 7067 5801

Contact Name: nice@nice.nhs.uk

Contact Email: nice@nice.nhs.uk

Copyright: National Institute for Clinical Excellence (NICE)