Prodrugs of 5-fluorouracil (5-FU) have been shown to be as effective as bolus 5-FU and folinic acid (FA) both in the metastatic and adjuvant setting for colon cancer treatment. Currently, oxaliplatin/5-FU is regarded as the standard adjuvant treatment, and improved response rates and prolonged survival support the use of irinotecan or oxaliplatin combined with 5-FU/FA. The use of oral compounds of 5-FU with irinotecan and oxaliplatin in patients with metastatic disease, however, is questionable due to toxicity concerns. Folprecht and Köhne explain why fluoropyrimidines remain an important component of first-line treatment and discuss which patients would benefit from monotherapy with fluoropyrimidines.
- Gunnar Folprecht
- Claus-Henning Köhne
