I Have Been Diagnosed
I Have Been Diagnosed With Stage III
Colon Cancer
I Have Been Diagnosed With Advanced
Colorectal Cancer
I Have Been Diagnosed With Stage III Colon Cancer
Being diagnosed with colon cancer can be overwhelming. It is normal to feel anxiety
and fear as you work through understanding your diagnosis and condition. But it
is important to know that you are not in this alone. There are many resources available
to you as you begin your fight against colorectal cancer.
Researching treatment options is the first step in managing colorectal cancer. At
ELOXATIN.com, you can:
I Have Been Diagnosed With Advanced Colorectal Cancer
A diagnosis of Stage IV, also known as advanced colorectal cancer, means the cancer
has metastasized, or spread, to distant organs like the liver or lungs. Your treatment
options include chemotherapy, surgery, and radiation.
Metastases
In advanced colorectal cancer, the cancer has spread or metastasized to other organs.
The most common site of metastases for colorectal cancer is the liver (in roughly
50% of cases). Because one of the liver’s main functions is to filter blood, cancer
cells from other parts of the body may become lodged in the liver and become tumors.
Another less common site of colorectal cancer metastases is the lungs (in about
25% of cases).
Treatment for metastases may be surgery or chemotherapy. One type of surgical treatment
for people with liver metastases is called
liver resection.
A good understanding of your condition and all of your options is the first step
in managing advanced colorectal cancer. At ELOXATIN.com you can learn:
About ELOXATIN
Studies have shown that ELOXATIN in combination with 5-FU/LV can increase survival
rates by 5.5%.
How is ELOXATIN Given
ELOXATIN is given with two other drugs: 5-fluorouracil (5-FU) and leucovorin.
Questions For Your Doctor
Chemotherapy Facts
What it is, how it’s given, how you’ll feel, and the side effects of chemotherapy.
Download Patient Guide to ELOXATIN Treatment (English)
Download Patient Guide to ELOXATIN Treatment (Spanish)
Download Patient Guide to ELOXATIN Treatment (Mandarin Chinese)
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INDICATIONS
Eloxatin® (oxaliplatin injection), used in combination with infusional
5-FU/LV, is indicated for
- Adjuvant treatment of stage III colon cancer patients who have undergone complete
resection of the primary tumor.
- Treatment of advanced carcinoma of the colon or rectum.
Clinical Safety Considerations
Anaphylactic-like reactions to ELOXATIN have been reported and may occur within
minutes of ELOXATIN administration. Epinephrine, corticosteroids, and antihistamines
have been employed to alleviate symptoms.
- ELOXATIN should not be administered to patients with a history of known allergy
to ELOXATIN or other platinum compounds. Hypersensitivity and anaphylactic/anaphylactoid
reactions to ELOXATIN have been reported and were similar in nature and severity
to those reported with other platinum compounds (ie, rash, urticaria, erythema,
pruritus, and, rarely, bronchospasm and hypotension). These reactions occur within
minutes of administration and should be managed with appropriate supportive therapy.
Drug-related deaths from this reaction have been reported.
- ELOXATIN may cause fetal harm when administered to a pregnant woman. Women of childbearing
potential should be advised not to become pregnant while receiving ELOXATIN. It
is not known whether ELOXATIN or its derivatives are excreted in human milk.
- ELOXATIN has been associated with pulmonary fibrosis (<1% of study patients),
which may be fatal. The combined incidence of cough and dyspnea was 7.4% (<1%
grade 3, no grade 4) in the ELOXATIN plus 5-FU/LV arm compared to 4.5% (no grade
3, 0.1% grade 4) in the 5-FU/LV alone arm in the adjuvant colon cancer study. In
this study, one patient died from eosinophilic pneumonia in the ELOXATIN combination
arm. The combined incidence of cough, dyspnea, and hypoxia was 43% (7% grade 3 and
4) in the ELOXATIN plus 5-FU/LV arm compared to 32% (5% grade 3 and 4) in the irinotecan
plus 5-FU/LV arm in patients with previously untreated colorectal cancer. In case
of unexplained respiratory symptoms, ELOXATIN should be discontinued until pulmonary
investigation excludes interstitial lung disease or pulmonary fibrosis.
- ELOXATIN is associated with two types of primarily peripheral sensory neuropathy:
an acute, reversible type of early onset and a persistent type (>14 days). In
patients with advanced colorectal cancer paresthesias occurred in 77% (all grades)
and 18% (grade 3/4) of previously untreated patients. In previously treated patients,
acute neuropathy occurred in 56% (all grades) and 2% (grade 3/4) of patients; persistent
neuropathy occurred in 48% (all grades) and 6% (grade 3/4) of patients. In patients
with stage II and III colon cancer, paresthesia was seen in 92% (all grades) and
13% (grade 3/4) of patients; 21% (all grades), 0.5% (grade 3/4) had residual paresthesia
at 18-month follow-up.
- Hepatotoxicity, as evidenced in the adjuvant study by increase in transaminases
and alkaline phosphatase was observed more commonly in the ELOXATIN combination
arm. The incidence of increased bilirubin was similar on both arms. Changes noted
on liver biopsies include: peliosis, nodular regenerative hyperplasia or sinusoidal
alterations, perisinusoidal fibrosis and veno-occlusive lesions. Hepatic vascular
disorders should be considered and, if appropriate, investigated in case of abnormal
liver function test results or portal hypertension not explained by liver metastases.
- Monitoring of white blood cell count with differential, hemoglobin, platelet count
and blood chemistries (including ALT, AST, bilirubin and creatinine) is recommended
before each ELOXATIN cycle.
- The safety and effectiveness of ELOXATIN plus 5-FU/LV in patients with renal impairment
have not been evaluated. Since the primary route of platinum elimination is renal,
this combination should be used with caution in patients with preexisting renal
impairment. Clearance of these products may be decreased by coadministration of
potentially nephrotoxic compounds, although this has not been specifically studied.
- The incidence of diarrhea, dehydration, hypokalemia, leukopenia, fatigue and syncope
were higher in patients ≥65 years old.
- Extravasation may result in local pain and inflammation that may be severe and lead
to complications, including necrosis. Injection site reaction, including redness,
swelling and pain, has been reported.
- There have been reports of prolonged prothrombin time and INR occasionally associated
with hemorrhage in patients receiving ELOXATIN plus 5-FU/LV while on anticoagulants.
Patients receiving ELOXATIN plus 5-FU/LV and requiring oral anticoagulants may require
closer monitoring.
- The most common adverse reactions in patients with stage II or III colon cancer
receiving adjuvant therapy were peripheral sensory neuropathy, neutropenia, thrombocytopenia,
anemia, nausea, increase in transaminases and alkaline phosphatase, diarrhea, emesis,
fatigue, and stomatitis. The most common adverse reactions in patients with advanced
colorectal cancer were peripheral sensory neuropathy, fatigue, neutropenia, nausea,
emesis, and diarrhea.
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