Irinotecan (Campto) in the treatment of pancreatic cancer.

Irinotecan (Campto) is a topoisomerase I inhibitor currently approved for the treatment of metastatic colon cancer. Single-agent irinotecan has also demonstrated modest activity in a number of other advanced solid tumors, including lung, gastric and pancreatic cancer. Preclinical data suggest a potentially additive and/or synergistic interaction between irinotecan and gemcitabine (Gemzar). This combination has demonstrated improved response rates in patients with pancreatic cancer. Unfortunately, a recently reported Phase III trial of gemcitabine with or without irinotecan revealed no survival benefit for the combination. Future combinations of irinotecan continue to be explored in an effort to further improve the treatment of this relatively chemorefractory disease. Thus far, no single agent or combination has been shown to be superior to gemcitabine alone as palliative therapy for advanced/metastatic pancreatic cancer. A promising combination of irinotecan with oxaliplatin (Eloxatin) and fluorouracil will be assessed in a Phase III study.