Drugs used in the treatment of colon cancer, includes usage in chemotherapy and targeted therapy.

Drugs used in chemotherapy :

Chemotherapy is a type of cancer treatment that involves the use of anti-cancer medications to kill cancer cells. Chemotherapy is divided into two categories: systemic and localised.

Drugs can be given intravenously or orally in systemic chemotherapy. Drugs are injected into the artery that leads to the section of the body with the tumour in regional chemotherapy. Both of these chemotherapies use a combination of medicines, including

  1. Capecitabine

Capecitabine is a chemotherapeutic medication that is used to treat cancer. This medication is used to treat colon cancer, rectal cancer, and breast cancer that has spread to other parts of the body.

Dosage, administration, and availability

Capecitabine is used orally and comes in pill form. The tablet should be swallowed whole, with no powder or damage. Within 30 minutes of eating a meal, take the tablet.

Availability

Tablets of 150 mg and 500 mg are available.

Dosage

1250 mg/m2 twice daily orally

Negative effects

The majority of patients who are given capecitabine do not have any negative effects. Even if side effects do occur, they are predictable in terms of when they will appear and how long they will last. The majority of these adverse effects are reversible and will go away after the treatment is over. Below is a list of the most prevalent adverse effects.

  • Vomiting and nausea
  • Diarrhea
  • Sores in the mouth
  • Appetite problems
  • Hand and foot syndrome is a condition that affects both hands and feet
  • Low levels of red blood cells
  • Itching of the eyes
  • Fever
  • Headache
  • Foot and ankle swelling
  • Itching and rashes
  • Pain in the abdomen
  • White blood cell count is low.
  • Muscle and bone pain in the back

Precautions

  • Inform your doctor about any other medications you're taking before commencing capecitabine treatment.
  • Do not receive any vaccinations or immunizations without first consulting your doctor.
  • Avoid eating antacids for at least two hours after taking capecitabine.
  • If you are hypersensitive to capecitabine, you should avoid it.
  • If you are pregnant, tell your doctor before starting capecitabine. The foetus is at risk from capecitabine.
  • While using capecitabine, do not try to conceive. Applicable on both men and women .
  • While using capecitabine, you should not breastfeed.
  1. Irinotecan

Irinotecan is a chemotherapeutic medication that is used to treat cancer. It's also a plant alkaloid and an inhibitor of topoisomerase I. This medication is used to treat colon cancer or rectal cancer that has spread or metastasized.

Dose, administration and  availability

Irinotecan is administered intravenously and is not available in tablet form. The amount of irinotecan provided is determined by a person's height and weight, as well as their overall health.

Availability

15 mL/300 mg

Dosage

350 mg/m2 for 90 minutes every three weeks as a single agent

Alternatively, 180 mg/m2 in conjunction with fluorouracil and leucovorin every three weeks for 90 minutes

Negative effects

The majority of persons who are given irinotecan do not have any negative effects. Even if side effects do occur, they are predictable in terms of when they will appear and how long they will last. The majority of these adverse effects are reversible and will go away after the treatment is over. Below is a list of the most prevalent adverse effects.

  • Vomiting and nausea
  • Diarrhea
  • Sores in the mouth
  • Appetite problems
  • Weakness
  • Low levels of red blood cells
  • Hair loss is a common problem.
  • Fever
  • Dehydration
  • Flatulence
  • Rash
  • Heartburn
  • Foot and ankle swelling
  • During the infusion, the face is flushed.
  • White blood cell levels are low.
  • Symptoms of the flu and chills

Precautions

  • Inform your doctor about any other medications you're taking before commencing irinotecan treatment.
  • Do not receive any vaccinations or immunizations without first consulting your doctor.
  • Laxatives and stool stimulants should be avoided because they can aggravate diarrhoea.
  • If you are pregnant, tell your doctor before starting the irinotecan treatment. The foetus is at risk from irinotecan.
  • If you're on irinotecan, don't try to conceive. This has an impact on both genders.
  • If you are taking irinotecan, you should not breastfeed.
  1. 5-fluorouracil

Fluorouracil and 5-fluorouracil are alternate names for 5-FU. It is a chemotherapeutic medication that is used to treat cancer. It's an anti metabolite, which is a type of chemotherapy. Antimetabolites are identical to the chemicals found in healthy cells. The cells are unable to divide when these chemicals are incorporated during cellular metabolism.

Colon cancer, rectal cancer, anal cancer, stomach cancer, and a variety of other cancers are all treated with this medicine.

Availability, dose, and administration

5-FU is administered intravenously as an injection.

500 mg injections are available.

Dosage

20-500mg2/day

Negative effects

The majority of persons who are given 5-FU do not have any negative side effects. Even if side effects do occur, they are predictable in terms of when they will appear and how long they will last. The majority of these adverse effects are reversible and will go away after the treatment is over. Below is a list of the most prevalent adverse effects.

  • Nausea and vomiting are common side effects.
  • Diarrhea
  • Sores in the mouth
  • Appetite problems
  • Light sensitivity and watery eyes
  • Blood counts are low.
  • The flavour of things changes.
  • Discoloration of the vein in which medicine is administered

Precautions

  • Inform your doctor about any other medications you're taking before commencing 5-FU treatment.
  • Do not receive any vaccinations or immunizations without first consulting your doctor.
  • If you are pregnant, tell your doctor before starting the 5-FU medication.
  • While on 5-FU medication, do not try to conceive. Applicable on men and women.
  • While on 5-FU treatment, do not breastfeed.
  1. Oxaliplatin

Oxaliplatin is a chemotherapeutic medication that is used to treat cancer. This medication is used to treat colon cancer that has spread or metastasized.

Availability dose, and administration

Oxaliplatin is an injectable drug that is not accessible in pill form. The amount of oxaliplatin required is determined by a number of parameters, including the patient's height and weight.

100mg infusion is available.

Every two weeks, dose 85 mg/2m2 through IV infusion for 120 minutes; given in combination with infusion 5-FU and leucovorin.

Negative effects

The majority of patients who are given oxaliplatin do not have any negative effects. Even if side effects do occur, they are predictable in terms of when they will appear and how long they will last. The majority of these adverse effects are reversible and will go away after the treatment is over. Below is a list of the most prevalent adverse effects.

  • Nausea and vomiting are common side effects.
  • Diarrhea
  • Sores in the mouth
  • Appetite problems
  • Peripheral neuropathy is a condition that causes tingling in the hands and feet.
  • Blood counts are low.
  • Breathing problems, jaw clenching
  • Fever
  • Headache
  • Cough
  • Reactions due to allergies
  • Constipation
  • Generalized discomfort

Precautions

  • Inform your doctor about any additional medications you're taking before commencing oxaliplatin treatment.
  • Do not receive any vaccinations or immunizations without first consulting your doctor.
  • If you are pregnant, tell your doctor before starting oxaliplatin. The foetus is at risk from oxaliplatin.
  • Do not try to conceive while using oxaliplatin.
  • While receiving oxaliplatin treatment, do not breastfeed.
  1. Trifluridine and tipiracil (combination in pill form)
  2. Leucovorin

In the treatment of colon cancer, leucovorin is a decreased folic acid that is used in conjunction with other chemotherapy to either improve effectiveness or act as a chemoprotectant.

Availability, dose, and administration

Leucovorin comes in pill form and can also be administered as an intravenous infusion or an intramuscular injection. The dosage administered to the patient is determined by several criteria, including the patient's weight, cancer kind, and overall health.

500 mg vials are available.

Dosage

Leucovorin (leucovorin calcium) is given at 200 mg/m2 via slow intravenous infusion over a minimum of 3 minutes, then 5-fluorouracil at 370 mg/m2 is given intravenously.

Or

Intravenous injections of leucovorin (leucovorin calcium) at 20 mg/m2 are followed by intravenous injections of 5-fluorouracil at 425 mg/m2.

Negative effects

The majority of persons have negative effects from chemotherapy medicines used in conjunction with leucovorin. The following is a list of the most common leucovorin adverse effects.

  • Allergic symptoms such as redness and itching on the face
  • Nausea and vomiting, both of which are uncommon.

Precautions

  • Inform your doctor about any other medications you're taking before commencing leucovorin treatment.
  • Do not receive any vaccinations or immunizations without first consulting your doctor.
  • If you are pregnant, tell your doctor before beginning therapy.
  • While taking leucovorin, do not try to conceive. It has an impact on both women and men.
  • If you're taking leucovorin, don't breastfeed.

Drugs used in targeted therapy

In comparison to chemotherapy, targeted therapy operates in a fundamentally different way. They can even work when regular chemotherapy fails, and the adverse effects are often quite different from what a person would experience with chemotherapy.

Drugs that target several functions are used in targeted therapy, such as:

Drugs that inhibit the formation of blood vessels

VEGF (vascular endothelial growth factor) is a protein that aids in the formation of new blood vessels in order for them to receive the nutrients they require to grow. The following medications are used to halt this process:

  1. Bevacizumab
  2. Ramucirumab

It's a monoclonal antibody, which means it only recognises one type of antigen. This medication is used to treat colon cancer that has spread to other parts of the body.

Availability , dose, and administration

Ramucirumab is administered intravenously as an infusion and is not accessible as a tablet.

The amount administered to the patient is determined by several factors, including the patient's weight and overall health.

100 mg/10 ml and 500 mg/50 ml are available.

8 mg/kg IV every two weeks for at least 60 minutes prior to FOLFIRI treatment.

Negative effects

The majority of persons who are given ramucirumab do not have any side effects. Even if side effects do occur, they are predictable in terms of when they will appear and how long they will last. The majority of these adverse effects are reversible and will go away after the treatment is over.

Below is a list of the most prevalent adverse effects.

  • Blood pressure that is too high
  • Diarrhea
  • Headache

Precautions

  • Inform your doctor about any other medications you're taking before commencing ramucirumab treatment.
  • Do not receive any vaccinations or immunizations without first consulting your doctor.
  • While on ramucirumab medication, check your blood pressure frequently.
  • If you are pregnant, tell your doctor before beginning therapy. Ramucirumab could be detrimental to a developing foetus.
  • While using ramucirumab, do not try to conceive.
  • While taking ramucirumab, you should not breastfeed.
  1. Ziv-Aflibercept

It is an antineoplastic medication that works by inhibiting vascular endothelial growth factor (VEGF). This medication is used to treat colon cancer that has spread to other parts of the body.

Availability, dose and administration

Ziv-Aflibercept is not available in pill form and must be administered intravenously for more than one hour on the same day as chemotherapy. The amount administered to the patient is determined by several factors, including the patient's weight and overall health.

Availability

(25 mg/mL) vial, 100 mg/4 mL

(25 mg/mL) 200 mg/8 mL vial

Dosage

IV infusion of 4 mg/kg every two weeks for one hour

Negative effects

The majority of patients who are treated with Ziv-Aflibercept do not have any side effects. Even if side effects do occur, they are predictable in terms of when they will appear and how long they will last. The majority of these adverse effects are reversible and will go away after the treatment is over. Below is a list of the most prevalent adverse effects.

  • Blood count is low.
  • Urinary protein
  • Diarrhoea
  • Sores in the mouth
  • Fatigue \sInfection
  • Bleeding
  • Hypertension
  • Appetite decreases
  • Loss of weight
  • Headaches
  • Pain in the abdomen
  • Breathing problems
  • Hand-foot syndrome is a condition that affects both hands
  • Anxiety in the eyes
  • Clots in the blood
  • Fistulas
  • Bleeding that is uncontrolled

Precautions

  • Inform your doctor about any other medications you're taking before commencing Ziv-Aflibercept treatment.
  • Do not receive any vaccinations or immunizations without first consulting your doctor.
  • Consult your doctor before undergoing any procedures or surgeries.
  • If you are pregnant, tell your doctor before beginning therapy.
  • While on Ziv-Aflibercept therapy, do not try to conceive. It has effect on both genders.
  • While using Ziv-Aflibercept, do not breastfeed.

Drugs that target epidermal growth factor receptor (EGFR) mutations in cells

Epidermal growth factor receptors (EGFRs) are proteins that aid in the proliferation of cancer cells. These proteins are targeted by the following drugs:

  1. Panitumumab

It is a monoclonal antibody that binds to epidermal growth factor and inhibits signal transmission. It's a medication that's used for targeted therapy. This medication is used to treat colon cancer that has spread or metastasized.

Availability, dose, and administration

Panitumumab is an intravenous immunoglobulin that is not accessible in tablet form. The medication is administered using an infusion pump. The amount of panitumumab given is determined by a person's height and weight, as well as their overall health.

Availability

Strength 20 mg Vectibix 100 mg

Dosage

Infusion of 6 mg/kg IV over 60 minutes

Negative effects

The majority of persons who are treated with panitumumab do not have any negative effects. Even if side effects do occur, they are predictable in terms of when they will appear and how long they will last. The majority of these adverse effects are reversible and will go away after the treatment is over. Below is a list of the most prevalent adverse effects.

  • Reactions on the skin
  • Skin that is parched
  • Nausea due to a low magnesium content in the blood
  • Diarrhea
  • Vomiting
  • Cough
  • Inflammation of the fingernail bed
  • Itching of the eyes
  • Pain in the abdomen
  • Deterioration in general
  • Foot and ankle swelling
  • Fatigue

Precautions

  • Inform your doctor about any other medications you're taking before commencing panitumumab treatment.
  • Do not receive any vaccinations or immunizations without first consulting your doctor.
  • While taking panitumumab, stay out of the sun.
  • If you are pregnant, tell your doctor before starting panitumumab medication.
  • Do not try to conceive while using panitumumab.
  • While taking panitumumab, do not breastfeed.

2.Cetuximab

Other targeted therapy drugs

  1. Regorafenib

is a targeted therapy medication that is used to treat cancer. It's a receptor tyrosine kinase inhibitor that's taken orally. Colon cancer is treated with this medication.

Availability, dose, and administration

Regorafenib comes in pill form and should be taken orally with a low-fat breakfast that has less than 30% fat. The tablets should not be crushed or dissolved and should be consumed whole.

  Availability

  Tablets containing 40 mg

Dosage

For the first 21 days of the 28-day cycle, take 160 mg (4x40mg pills) PO every day.

Negative effects

The majority of persons who are treated with regorafenib do not experience any side effects. Even if side effects do occur, they are predictable in terms of when they will appear and how long they will last. The majority of these adverse effects are reversible and will go away after the treatment is over. Below is a list of the most prevalent adverse effects.

  • Anemia
  • Increased levels of liver enzymes
  • Protein in urine causes fatigue.
  • Calcium deficiency
  • phosphorous deficiency
  • White blood cell count is low.
  • Appetite decreases
  • High bilirubin levels in the blood
  • Hand-foot syndrome is a condition that affects both hands
  • Diarrhea
  • Platelets are in short supply.
  • Sores in the mouth
  • Loss of weight
  • Infection
  • Blood pressure that is too high
  • Nausea
  • Increased Bleeding Pain Fever Rash Decreased blood clotting
  • Headache

Precautions

  • Inform your doctor about any other medications you may be taking before beginning therapy.
  • Do not receive any vaccinations or immunizations without first consulting your doctor.
  • While on regorafenib treatment, check your blood pressure frequently.
  • If you are pregnant, tell your doctor before beginning therapy. Regorafenib could be hazardous to a developing foetus.
  • While taking regorafenib, do not try to conceive. It has a negative effect on both women and men.
  • While taking regorafenib, you should not breastfeed.
  • Grapefruit juice or grapefruit should not be consumed since it may raise the level of regorafenib in the blood.
  • If you're using a blood thinner, you should have your blood levels monitored as directed.