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Brief Summary

GUIDELINE TITLE

Use of raltitrexed (Tomudex) in the management of metastatic colorectal cancer.

BIBLIOGRAPHIC SOURCE(S)

  • Gastrointestinal Disease Site Group. Germond C, Maroun J, Zwaal C, Wong S. Use of raltitrexed (Tomudex) in the management of metastatic colorectal cancer. Toronto (ON): Cancer Care Ontario (CCO); 2005 Feb 10. 13 p. (Practice guideline report; no. 2-17). [22 references]

GUIDELINE STATUS

This is the current release of the guideline.

The FULL REPORT, initially the full original Guideline, over time will expand to contain new information emerging from their reviewing and updating activities.

Please visit the Cancer Care Ontario Web site for details on any new evidence that has emerged and implications to the guidelines.

BRIEF SUMMARY CONTENT

 RECOMMENDATIONS
 EVIDENCE SUPPORTING THE RECOMMENDATIONS
 IDENTIFYING INFORMATION AND AVAILABILITY
 DISCLAIMER

 Go to the Complete Summary

RECOMMENDATIONS

MAJOR RECOMMENDATIONS

  • For patients with previously untreated metastatic colorectal cancer in whom chemotherapy is indicated, a combination of 5-fluorouracil (5-FU) plus leucovorin (LV) and irinotecan is now the standard treatment regimen.
  • For patients with previously untreated metastatic colorectal cancer where monotherapy with fluoropyrimidines or other thymidylate synthase inhibitors (e.g. 5-FU/LV or capecitabine) appears appropriate, it is reasonable to offer raltitrexed as a therapeutic option. Suitable patients would include those for whom toxicity from 5-FU is a concern (such as patients who are over 60 years in age or women), or for whom the more convenient administration schedule of raltitrexed is important (one visit for raltitrexed every three weeks versus five daily visits with 5-FU every four weeks).
  • At this time, there is insufficient evidence to make a recommendation for or against the use of raltitrexed in patients who progress on 5-FU/LV.

CLINICAL ALGORITHM(S)

None provided

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EVIDENCE SUPPORTING THE RECOMMENDATIONS

TYPE OF EVIDENCE SUPPORTING THE RECOMMENDATIONS

The recommendations are supported by randomized trials and meta-analyses.

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IDENTIFYING INFORMATION AND AVAILABILITY

BIBLIOGRAPHIC SOURCE(S)

  • Gastrointestinal Disease Site Group. Germond C, Maroun J, Zwaal C, Wong S. Use of raltitrexed (Tomudex) in the management of metastatic colorectal cancer. Toronto (ON): Cancer Care Ontario (CCO); 2005 Feb 10. 13 p. (Practice guideline report; no. 2-17). [22 references]

ADAPTATION

Not applicable: The guideline was not adapted from another source.

DATE RELEASED

1998 May 22 (revised 2005 Feb)

GUIDELINE DEVELOPER(S)

Program in Evidence-based Care - State/Local Government Agency [Non-U.S.]

GUIDELINE DEVELOPER COMMENT

The Program in Evidence-based Care (PEBC) is a project supported by Cancer Care Ontario and the Ontario Ministry of Health and Long-Term Care.

SOURCE(S) OF FUNDING

Cancer Care Ontario, Ontario Ministry of Health and Long-Term Care

GUIDELINE COMMITTEE

Provincial Gastrointestinal Cancer Disease Site Group

COMPOSITION OF GROUP THAT AUTHORED THE GUIDELINE

Primary Authors: Germond C, Maroun J, Zwaal C, Wong S

For a current list of past and present members of the Gastrointestinal Disease Site Group, please see the Cancer Care Ontario Web site.

FINANCIAL DISCLOSURES/CONFLICTS OF INTEREST

Not stated

GUIDELINE STATUS

This is the current release of the guideline.

The FULL REPORT, initially the full original Guideline, over time will expand to contain new information emerging from their reviewing and updating activities.

Please visit the Cancer Care Ontario Web site for details on any new evidence that has emerged and implications to the guidelines.

GUIDELINE AVAILABILITY

Electronic copies: Available in Portable Document Format (PDF) from the Cancer Care Ontario Web site.

AVAILABILITY OF COMPANION DOCUMENTS

The following are available:

PATIENT RESOURCES

The following is available:

Please note: This patient information is intended to provide health professionals with information to share with their patients to help them better understand their health and their diagnosed disorders. By providing access to this patient information, it is not the intention of NGC to provide specific medical advice for particular patients. Rather we urge patients and their representatives to review this material and then to consult with a licensed health professional for evaluation of treatment options suitable for them as well as for diagnosis and answers to their personal medical questions. This patient information has been derived and prepared from a guideline for health care professionals included on NGC by the authors or publishers of that original guideline. The patient information is not reviewed by NGC to establish whether or not it accurately reflects the original guideline's content.

NGC STATUS

This summary was completed by ECRI on August 19, 1999. The information was verified by the guideline developer as of September 17, 1999. This NGC summary was updated by ECRI on December 14, 2001, July 21, 2003, and September 8, 2005. The updated information was verified by the guideline developer on October 3, 2005.

COPYRIGHT STATEMENT

This NGC summary is based on the original guideline, which is subject to the guideline developer's copyright restrictions. Please refer to the Copyright and Disclaimer Statements posted at the Cancer Care Ontario Web site.

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DISCLAIMER

NGC DISCLAIMER

The National Guideline Clearinghouse™ (NGC) does not develop, produce, approve, or endorse the guidelines represented on this site.

All guidelines summarized by NGC and hosted on our site are produced under the auspices of medical specialty societies, relevant professional associations, public or private organizations, other government agencies, health care organizations or plans, and similar entities.

Guidelines represented on the NGC Web site are submitted by guideline developers, and are screened solely to determine that they meet the NGC Inclusion Criteria which may be found at http://www.guideline.gov/about/inclusion.aspx .

NGC, AHRQ, and its contractor ECRI Institute make no warranties concerning the content or clinical efficacy or effectiveness of the clinical practice guidelines and related materials represented on this site. Moreover, the views and opinions of developers or authors of guidelines represented on this site do not necessarily state or reflect those of NGC, AHRQ, or its contractor ECRI Institute, and inclusion or hosting of guidelines in NGC may not be used for advertising or commercial endorsement purposes.

Readers with questions regarding guideline content are directed to contact the guideline developer.
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