Chemotherapy Treatment of Advanced Colorectal Cancer

Stage 4 colorectal cancer has changed vastly in the past twenty years.  A disease that was almost always a death sentence now is met with better quality of life and a longer time of survival.  Most patients with Stage 4 colorectal cancer have disease that has already spread and cannot be removed with surgery, so systemic treatment that can kill cancer cells throughout the body is necessary. 

Systemic treatment is called chemotherapy.  Chemotherapy can also destroy cancer cells that have metastasized to parts of the body away from the original tumor site. Combining two or more chemotherapy agents can be used for treatment of colorectal cancer, as this will help to provide a better response overall.

  The following chemotherapy drugs have been approved for colorectal cancer:


These treatments are usually provided in combinations:

  • FOLFOX (LV/5-fluorouracil + Eloxatin (oxaliplatin)
  • XELOX (Xeloda, Eloxatin, leucovorin) 
  • CAPEOX (Xeloda (capecitabine) + Eloxatin)
  • FOLFIRI (LV/5-fluorouracil + Camptosar (irinotecan)
  • FOLFOXIRI (LV/5-fluorouracil + Camptosar + Eloxatin)


Normally, the above combinations are the initial treatment standard for colorectal cancer.  Later, they are paired with Avastin® (bevacizumab) to improve response. Sometimes chemotherapy and other treatments can cause side effects.  Visit our EASE page to discover helpful hints on how to deal with the possible aftermath of treatment.

Chemotherapy can also be used in combination with immuno-oncology or immunotherapy.