Update in cancer chemotherapy: gastrointestinal cancer--colorectal cancer, Part 1.

An update of the state of the art of cancer chemotherapeutic treatment of gastrointestinal tract cancer is described. A review of cancers of the colon, rectum, anus, pancreas, stomach, small intestine, biliary passages, liver, and esophagus will be published in a multiple-part series. Part 1 will survey colorectal cancer and the use of single-agent chemotherapy.In advanced gastrointestinal tract cancer, chemotherapy is only of palliative value with response rates generally under 50 percent and with duration of several months to one year or more. Combination chemotherapy often produces higher response rates, yet there is no acceptable evidence that survival is improved. While some adjuvant chemotherapy trials suggest improvement, major survival gains remain to be demonstrated. Uncertainty as to the role of chemotherapy in the treatment of gastrointestinal cancers may be due to lack of data.