© 2003 European Society for Medical Oncology Progress in the treatment of gastrointestinal cancer

Colorectal cancer (CRC) is common and is associated with a high mortality, due principally to the tendency of the disease to spread to other organs, notably the liver. While adjuvant chemotherapy has been shown to improve survival in stage III patients, its role in stage II disease has not yet been established [1]. The incorpora-tion of new and active cytotoxic agents such as irinotecan into adjuvant regimens may further benefit survival, as may the intro-duction of novel cytostatics targeted at processes promoting malignant spread. On the neoadjuvant front there are also encour-aging prospects: use of chemotherapy that achieves major responses is enabling certain patients with initially unresectable disease to proceed to potentially curative surgery. However, in the foreseeable future there will continue to be a massive need for palliative chemotherapy among patients with advanced disease. Fortunately, there is a history of progress her