Daniel G. Haller, MD

Commentary (Hewitt/Haller): Adjuvant Therapy for Colorectal Cancer

April 17, 2006

During the 1980s, the only drug routinely used to treat colorectal carcinoma was single-agent fluorouracil (5-FU), a drug that had shown no proven benefit in the adjuvant setting. Since then, significant improvements in the overall management of colorectal cancer have been made. This review will compare today's standard of care for adjuvant colorectal carcinoma to that practiced 20 years ago. The authors examine key questions asked about adjuvant therapy and the answers that ultimately changed clinical practice standards and improved overall survival for patients diagnosed with this disease. In addition, this review explores whether 5-FU should be given as part of a multidrug regimen and which route of administration is best when this drug is given. Further, the authors delve into both the use of locally directed therapies to the liver or peritoneum to improve outcomes and the selection of patients to receive adjuvant chemotherapy. Finally, a look to the future shows monoclonal antibodies to be an avenue of great promise in fighting colorectal cancer.

Commentary (Sun/Haller)—Metastatic Colorectal Cancer: Is There One Standard Approach?

August 1, 2005

Advances in the treatment of
metastatic colorectal cancer in
the past several years have
been expeditious and exciting—even
chaotic—but with the median survival
doubled since the use of single-agent
fluoropyrimidines alone. However, new
questions continue to arise, directly affecting
our daily practice in the care of
patients with colorectal cancer. One of
these issues, the optimal therapy for
metastatic colorectal cancer, is wonderfully
explored by Dr. Saltz in this
issue of ONCOLOGY. To understand
this issue better, we may have to approach
the question a little differently:
That is, is it possible to standardize
treatment options for metastatic colorectal
cancer?

Commentary (Sun/Haller)—Metastatic Colorectal Cancer: Is There One Standard Approach?

August 1, 2005

Advances in the treatment of
metastatic colorectal cancer in
the past several years have
been expeditious and exciting—even
chaotic—but with the median survival
doubled since the use of single-agent
fluoropyrimidines alone. However, new
questions continue to arise, directly affecting
our daily practice in the care of
patients with colorectal cancer. One of
these issues, the optimal therapy for
metastatic colorectal cancer, is wonderfully
explored by Dr. Saltz in this
issue of ONCOLOGY. To understand
this issue better, we may have to approach
the question a little differently:
That is, is it possible to standardize
treatment options for metastatic colorectal
cancer?

Concurrent RT With 5-FU/Epirubicin and Cisplatin or Irinotecan for Locally Advanced Upper GI Adenocarcinoma

December 4, 2004

From the results of recent studies, it is likely that multimodality
therapy with chemotherapy and radiation treatment may improve the
overall outcome of locally advanced upper gastrointestinal (GI) malignancies,
including esophageal, gastric, pancreatic, and biliary tract carcinomas.
However, more effective, more optimal, and less toxic chemotherapy
regimen(s) with concomitant radiotherapy are needed beyond
the concurrent continuous-infusion fluorouracil (5-FU) with radiation
that is commonly applied in general practice. Epirubicin (Ellence),
cisplatin, and irinotecan (Camptosar) are all active cytotoxic chemotherapy
agents in upper GI cancers. Two phase I studies were designed
to test the tolerability of the combination of radiotherapy with infusional
5-FU, epirubicin, and cisplatin (ECF) or 5-FU, irinotecan, and
epirubicin (EIF) in the treatment of locally advanced upper GI malignancies.

Concurrent RT With 5-FU/Epirubicin and Cisplatin or Irinotecan for Locally Advanced Upper GI Adenocarcinoma

December 4, 2004

From the results of recent studies, it is likely that multimodality therapy with chemotherapy and radiation treatment may improve the overall outcome of locally advanced upper gastrointestinal (GI) malignancies, including esophageal, gastric, pancreatic, and biliary tract carcinomas. However, more effective, more optimal, and less toxic chemotherapy regimen(s) with concomitant radiotherapy are needed beyond the concurrent continuous-infusion fluorouracil (5-FU) with radiation that is commonly applied in general practice. Epirubicin (Ellence), cisplatin, and irinotecan (Camptosar) are all active cytotoxic chemotherapy agents in upper GI cancers. Two phase I studies were designed to test the tolerability of the combination of radiotherapy with infusional 5-FU, epirubicin, and cisplatin (ECF) or 5-FU, irinotecan, and epirubicin (EIF) in the treatment of locally advanced upper GI malignancies.