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Chemotherapy for advanced colorectal cancer

The development of 5-fluorouracil (5-FU) some 40 years ago was among the earliest events in the field of chemotherapy. Until recently, 5-FU remained the only drug of hundreds tested with reproducible activity in colorectal cancer. Many years elapsed before the palliative benefit of 5-FU in metastatic disease translated to a curative effect in Dukes C and possibly Dukes B patients. This established a paradigm in colorectal cancer by which development in the metastatic setting was viewed as conferring survival or quality-of-life benefit in these patients, but most importantly as laying the groundwork for efficacy in adjuvant therapy.