Eloxatin - A New Option for Cancer of The Colon

More people in Singapore are diagnosed with colorectal cancer than any other types of cancer. On a global scale, it is the third leading cause of cancer, and accounts for 10 per cent of cancer deaths worldwide.

Currently, the main treatment for colorectal cancer is surgery, where the tumour is removed along with a length of the colon on either side of the cancer. Chemotherapy is used as post-surgical treatment, as is radiotherapy. A patient who undergoes chemotherapy after surgery is found to have an increased chance of survival, as chemotherapy works to destroy residual cancer cells that still remain in the body.

The standard chemotherapy program for colorectal cancer has long been 5-fluorouracil-folinic acid (5-FU/FA), and this has been held as the only useful treatment for colorectal cancer. But two new drugs approved in Singapore in 1996/97 have made a difference to this established treatment for colorectal cancer. One if these is oxalipatin.

"The beauty of this drug is that when you use it in combination with 5-FU/FA, it is very much more effective than the standard treatment of 5-FU/FA," said Dr Ang Peng Tiam, Consultant Medical Oncologist, Mount Medical Centre.

"Another advantage is that it has minimal side effects," Dr Ang explained further, adding, "there's no hair loss, hardly or no nausea/vomiting, and no diarrhoea. So because of the high level of effectiveness and low-side effect profile, it is a favoured drug in the treatment of colorectal cancer."

In a landmark international trial called the Multicentre International Study of Oxalipatin/S-FU- Leucovorin (LV) in the Adjuvant Treatment of Colon Cancer, also referred to as the MOSAIC study, it was found that the addition of oxalipatin to the standard adjuvant treatment (post-operative treatment) significantly reduced the risk of cancer recurrence or relapse.

Shedding light on the results of this study, Dr Ang had this to say, "The Mosaic study was important because instead of using the standard chemotherapy treatment of 5-FU/FA, patients were given oxalipatin/5-FU/FA. And they found that there was a 25 per cent increase in benefit for the patient who took this treatment."

"So in other words, for stage III cancer, we can improve upon the cure rate of patients, compared to the old standard chemotherapy," said Dr Ang. Eloxation (oxalipatin), by Sanofl-Synthelabo, is a platinum-based anti-cancer drug that works by forming a chemical bond with deoxyribonucleic acid (DNA) to disrupt cancer cell growth. As a first-line treatment for metastatic colon cancer, Eloxatin has proven to be effective, while results of the MOSAIC study testify to its success rate in the adjuvant treatment of colorectal cancer.

Summarising the benefits of Eloxatin, Dr Ang said, "The first important finding is that we have shown we can improve the cure rate of colorectal cancer after surgery has been carried out. Secondly, we can shrink and control the disease for patients who have metastatic colorectal cancer. More importantly, we achieve this with minimal side effects, translating into better quality of life." Eloxatin has been approved for use in Singapore, and it has shown marked levels of activity in advanced colorectal cancer.

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