Colorectal cancer: Adverse effects of antineoplastic treatment

Colorectal cancer is a serious public health problem and one of the major causes of death from neoplastic disease. Currently, four antineoplastic-chemotherapy agents (5-fluorouracil, oxaliplatin, irinotecan and capecitabine) have been approved for the treatment of this disease. These agents have enhanced the efficacy of treatment and increased the survival of patients with colorectal cancer. Although their clinical results are good, these forms of treatment have also caused a range of adverse effects, some of which may be severe. The toxicity of these agents may be dose-limited and can affect the overall treatment plan. Procedures for the management of the toxic effects of the chemotherapeutic agents are related to both the prevention and the early recognition and treatment of specific adverse events. Relevant guidelines should be included in the general treatment plan and their use would lead to a reduction of treatment breaks or cessation, and also to improvement of the quality of life of the patients. Finally, the discovery of new predictive markers of the efficacy of the various different forms of treatment could reduce the administration of a specific agent to patients in whom it probably would be of no benefit. Consequently, the approach of personalized treatment in colorectal cancer could substantially reduce the risk of possible excess toxicity.