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New Hope for Cancer Treatment: What is the Miraculous Journey of Irinotecan?
In the journey of cancer treatment, irinotecan, as an important member of the anti-cancer drug family, has demonstrated its outstanding therapeutic potential. Since being approved in the United States in 1996, this drug has not only been widely used in the treatment of colon cancer and small cell lung cancer, but has also been continuously introduced to bring new hope to patients.
The birth background of irinotecan comes from the Chinese ornamental plant "Camptotheca acuminata", and the natural compound "camptotheca acuminata" extracted from it provides the basis for its therapeutic effect.
Irinotecan is often used in combination with other chemotherapy drugs, especially in the treatment of colon cancer. Combination regimens such as FOLFIRI (a chemotherapy regimen containing fluorouracil and folic acid) have shown significant efficacy. In 2024, irinotecan liposome combined with oxaliplatin, fluorouracil and folic acid was approved by the FDA as a first-line treatment for metastatic pancreatic adenocarcinoma.
Side Effects and Risk Assessment
Although irinotecan has excellent therapeutic performance, its side effects cannot be ignored. The most common side effects include diarrhea, vomiting, bone marrow suppression, hair loss, and fever. Some patients may even experience serious side effects such as blood clots, intestinal inflammation, or allergic reactions.
Among patients receiving irinotecan, those with the "UGT1A1*28" gene mutation face a higher risk of side effects.
For example, early diarrhea often occurs during or shortly after drug infusion and is short-lived in most cases. However, delayed diarrhea may occur more than 24 hours after administration and may be life-threatening. Severe cases may require hospitalization or even admission to the intensive care unit.
Mechanism and function
Irinotecan is a topoisomerase inhibitor. Its main mechanism of action is to inhibit topoisomerase I, an important enzyme, which in turn causes DNA damage and cancer cell death. This mechanism is achieved through the active metabolite SN-38. The drug exhibits significant variability in renal clearance and hepatic metabolism, and disease transmission or environmental factors may affect patient response to irinotecan.
Individual differences and genetic testing
for
UGT1A1
Knowledge of genetic polymorphisms provides a more personalized approach to irinotecan treatment. especially those who have
Patients with *28 mutation
More likely to face serious side effects from treatment. The FDA updated dosing instructions in 2005 to recommend that these patients consider dose reduction, making irinotecan one of the first chemotherapy drugs to rely on genotype for dose adjustment.
Looking forward to future research and applications
With the deepening of research on irinotecan, different combination therapies and new usage regimens are constantly emerging, which will bring hope to more cancer patients. The scientific community also hopes to further understand the impact of different genes and individual differences on the efficacy of irinotecan, so as to provide patients with more targeted treatments. This is not only the progress of science, but also the continuation of hope.
As a "rising star" in anti-cancer treatment, the scientific and clinical data behind irinotecan will always inspire innovative thinking in the medical community.
In this fight against cancer, the medical progress brought about by irinotecan is very exciting and has changed the lives of countless patients. Facing the future, how will the medical community continue to explore the potential of irinotecan to help more cancer patients embrace a new life?
