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Predictive factors for chemotherapy-related toxic effects in patients with colorectal cancer

Nature Clinical Practice Oncology volume 5, pages 455–465 (2008)Cite this article

Abstract

Colorectal cancer represents a major health problem in the Western world. Many drugs have been used for the treatment of this disease, but there is little information about how predictive factors can be used to aid treatment response and anticipate toxic effects related to anticancer treatment in colorectal cancer. In this Review we analyze the main data about this field of investigation, and highlight the most important predictive factors that relate to the toxic effects experienced by colorectal cancer patients treated with anticancer chemotherapy, both in the adjuvant and in the advanced settings. The predictive factors are grouped on the basis of the different anticancer drugs. We discuss the rationale for tailoring anticancer treatment in patients with colorectal cancer according to individual molecular and clinical features, with the aim of improving response rates and reducing the incidence of toxic events.

Key Points

  • It is becoming increasingly important to identify the clinical and molecular factors that will help to optimize the efficacy and/or reduce the toxic effects of anticancer treatments

  • There is a significant association between 5-FU toxic effects and the following parameters: age; gender; race; ECOG performance status; variant of dihydropyrimidine dehydrogenase; thymidylate synthase enzymes; and polymorphisms in the methylenetetrahydrofolate reductase gene

  • Low plasma concentration of 7-ethyl-10-hydroxycamptothecine (SN-38) and altered

  • SN-38 glucuronidation are predictive of irinotecan-related adverse events

  • No clinical or molecular factor has been shown to have an important role in identifying patients more likely to experience oxaliplatin-related toxic events

  • One of the greatest challenges for clinicians will be the identification of predictive factors for toxic effects related to targeted therapies

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  1. and G Tonini is Chief of the Division, all in the Division of Medical Oncology at the University Campus Bio-Medico of Rome, B Vincenzi and D Santini are Medical Oncologists, G Schiavon and F Pantano are Residents, Rome, Italy.,

    Bruno Vincenzi, Gaia Schiavon, Francesco Pantano, Daniele Santini & Giuseppe Tonini

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Correspondence to Bruno Vincenzi.

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Vincenzi, B., Schiavon, G., Pantano, F. et al. Predictive factors for chemotherapy-related toxic effects in patients with colorectal cancer. Nat Rev Clin Oncol 5, 455–465 (2008). https://doi.org/10.1038/ncponc1137

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