Kemoterapeutikumok, terápiás válasz és reziztencia-mechanizmusok a colorectalis carcinoma kezelésében

Translated title of the contribution: Chemotherapy agents, response rates and mechanisms of resistance in the therapy of the colorectal carcinoma

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Colorectal carcinoma is one of the most common cancers in Hungary, responsibe for about 5000 deaths each year. In the first line treatment the most commonly used drugs are 5-fluorouracil, oxaliplatin and irinotecan. The most frequently used drug is 5-fluorouracil, which has no effect in 90% of the cases. In combination with leukovorin or with 5-ethyl-2'-deoxyuridin fluorouracil has an increased effect. The main mechanisms of the resistance against 5-fluorouracil are due to the overexpression of dihydropyrimidine dehydrogenase, MRP8, thymidylate synthase, and NF?B p65. Oxaliplatin forms reactive platinum complexes, which are believed to inhibit DNA synthesis by forming interstrand and intrastrand cross-linking of DNA molecules. The oxaliplatin-5-fluorouracil- leucovorin combination was the first to reach more than 20 months median survival. The main mechanisms of resistance are decreased accumulation, increased detoxification and increased DNA repair. Irinotecan inhibits the topoisomerase I enzyme, resulting in the inhibition of the repair of DNA breaks occurring during DNA synthesis. With sequential 5-fluorouracil, oxaliplatin, irinotecan combination 26 months median survival was reached. Mechanisms resulting in resistance are decreased accumulation, increased enzymatic detoxification, alterations of ABC transporters, DNA repair system, apoptotic pathways and topoisomerase I. Survival can be elongated using biological therapy (cetuximab, bevacizumab). In the near future biologial therapy is expected to spread.

Translated title of the contributionChemotherapy agents, response rates and mechanisms of resistance in the therapy of the colorectal carcinoma
Original languageHungarian
Pages (from-to)315-323
Number of pages9
JournalMagyar onkologia
Volume50
Issue number4
Publication statusPublished - Dec 1 2006

ASJC Scopus subject areas

  • Medicine(all)

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