[Oxaliplatin tolerance in the treatment of metastatic colorectal cancers].

Oxaliplatin is a new platinum compound with a 1,2-diaminocyclohexane (DACH) carrier ligand. It has recently been developed in metastatic colorectal cancer treatment, where it is generally combined with 5FU and leucovorin. Safety data in this indication concern over 1,700 patients, who received 12,500 cycles during clinical trials. Oxaliplatin appears to be relatively well tolerated and easy to handle, even on an outpatient basis. Gastrointestinal toxicity is common, but controllable and rarely severe or long-lasting. Haematological and mucosal tolerance is satisfactory, and oxaliplatin does not seem to have renal toxicity. Neurological side effects are the drug's limiting toxicity and can present as acute neurotoxicity (dysesthesiae), which is rapidly reversible, or sometimes as a longer-lasting effect, correlated in this case with the cumulative dose and leading to functional impairment in 10 to 20% of patients after 6 cycles or more. Neurological symptoms improve in the vast majority of cases after treatment is stopped. In this situation, it is even possible to restart oxaliplatin treatment. Good patient information and dose adjustments should allow us to manage the majority of neurological toxicity associated with oxaliplatin administration.