Raltitrexed is a specific thymidylate synthase inhibitor which has demonstrated activity similar to that of bolus FU and LV for the first-line treatment of advanced colorectal cancer. The recommended dose is 3.0 mg/m2 every three weeks. Median survival and response rate were comparable to that of bolus or infusional FU-LV. As with other cytotoxic agents, serious and potentially life-threatening side effects can occur: particularly diarrhoea and neutropenia. The incidence of serious side effects may be minimised with the assessment of renal function before and after every treatment and dosage adjustment in the presence of renal impairment .
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