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Irinotecan is a topoisomerase inhibitor used for chemotherapy. It is a water-soluble analogue of [camptothecin], which is extracted from the Chinese tree _Camptotheca acuminate_.[A263376] The bis-piperidine side chain in the structure of irinotecan bestows enhanced water solubility.[A263381] As an anticancer drug, irinotecan was first commercially available in Japan in 1994 to treat various cancers such as lung, cervical and ovarian cancer.[A263376] Approved by the FDA in 1996,[A263366] irinotecan is used to treat colorectal cancer and pancreatic adenocarcinoma.[L50181, L50186, L50201] Irinotecan liposome was approved by the FDA in February 2024.[L50186] The active metabolite SN-38 is also a potent inhibitor of DNA topoisomerase I. Both irinotecan and SN-38 mediate antitumor activity by forming a complex with topoisomerase I and blocking its enzymatic activity, thereby interfering with DNA synthesis. This leads to the arrest of the cell cycle in the S-G2 phase and cancer cell death.[A263376]
Irinotecan is indicated for the treatment of: - Metastatic carcinoma of the colon or rectum as first-line treatment in combination with [fluorouracil] and [leucovorin].[L50181, L50201] - Metastatic carcinoma of the colon or rectum whose disease has recurred or progressed following initial fluorouracil-based therapy, as monotherapy [L50201] or in combination with [fluorouracil] and [leucovorin].[L50181] Irinotecan liposome injection is used in adults for the treatment of: - Metastatic pancreatic adenocarcinoma in combination with [oxaliplatin], [fluorouracil], and [leucovorin] as first-line treatment.[L50186] - Metastatic pancreatic adenocarcinoma in combination with [fluorouracil] and [leucovorin] after disease progression following gemcitabine-based therapy.[L50186]
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