Safety of Oxaliplatin in the Treatment of Colorectal Cancer

ABSTRACT: The new platinum compound oxaliplatin (Eloxatin) appears tohave activity, either alone or in combination, as both first- and second-linetherapy for advanced colorectal cancer. Unlike other platinum derivatives, it isnot associated with significant nephrotoxicity or ototoxicity. The addition ofoxaliplatin at 85 mg/m2 to afluorouracil/leucovorin-based regimen administered every 2 weeks is welltolerated. The incidence of diarrhea and stomatitis increases with the additionof oxaliplatin, but can be managed by adjusting the dose. There is also asignificantly higher incidence of grade 3 or 4 neutropenia with oxaliplatin.Neutropenic febrile complications are rare. The occurrence of other hematologic,hepatic, or renal toxicities does not increase when oxaliplatin is added tofluorouracil-based regimens. Unlike other agents used for the treatment ofcolorectal cancer, oxaliplatin causes acute and chronic neurosensory symptoms.These acute symptoms are managed by taking precautions (eg, avoid colddrinks/food for a few days following treatment). Cumulative neurotoxicity is thedose-limiting toxicity associated with oxaliplatin treatment. This toxicityappears reversible with discontinuation of the drug and typically occurs wellafter the onset of tumor response. [ONCOLOGY14(Suppl 11):15-20, 2000]

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