Irinotecan (Camptosar)

==General information==
Class/mechanism: Topoisomerase I inhibitor; derivative of camptothecin, which interferes with topoisomerase I's normal action of relieving torsional strain in DNA by creating reversible single-strand breaks. Irinotecan and its active metabolite SN-38 bind to the topoisomerase I & DNA complex and interfere with ligation of these single-strand breaks. Failure to repair these breaks eventually leads to double-strand DNA damage, which disrupts cell proliferation and leads to cell death.Irinotecan (Camptosar) package insertIrinotecan (Camptosar) package insert (locally hosted backup)
Route: IV
Extravasation: irritant
For conciseness and simplicity, HemOnc.org currently will focus on treatment regimens and not list information such as: renal/hepatic dose adjustments, metabolism (including CYP450), excretion, monitoring parameters (although this will be considered for checklists), or manufacturer. Instead, for the most current information, please refer to your preferred pharmacopeias or the prescribing information. 
==Diseases for which it is used==
*Carcinoma of unknown primary 
*Anaplastic glioma
*Cervical cancer
*Colorectal cancer
**Rectal cancer
*Esophageal cancer
**Esophageal adenocarcinoma
**Esophageal squamous cell carcinoma
*Ewing sarcoma
*Gallbladder cancer
*Gastric cancer
*Glioblastoma
*Hepatoblastoma
*Neuroblastoma
*Non-small cell lung cancer
*Pancreatic cancer 
*Penile cancer 
*Rhabdomyosarcoma
*Small cell lung cancer
==Patient drug information==
*Irinotecan (Camptosar) package insert
*Irinotecan (Camptosar) patient drug information (Chemocare)Irinotecan (Camptosar) patient drug information (Chemocare)
*Irinotecan (Camptosar) patient drug information (UpToDate)Irinotecan (Camptosar) patient drug information (UpToDate)
==History of changes in FDA indication==
* 1996-06-14: Initial accelerated approval for the treatment of patients with metastatic carcinoma of the colon or rectum whose disease has recurred or progressed following 5-FU-based therapy. (Based on Rothenberg et al. 1996, Pitot et al. 1997, Rougier et al. 1997, and Rothenberg et al. 1999)
**1998-10-22: Converted to regular approval for the treatment of patients with metastatic carcinoma of the colon or rectum whose disease has recurred or progressed following 5-FU-based therapy. (Based on V301 & V302)
* 2000-04-20: Indicated as a component of first-line therapy in combination with 5-fluorouracil and leucovorin for patients with metastatic carcinoma of the colon or rectum. (Based on Douillard et al. 2000 & Saltz et al. 2000)
==History of changes in EMA indication==
*1995-05-05: EURD
==History of changes in PMDA indication==
*2013-03-25: New additional indication and a new dosage for the treatment of pediatric malignant solid tumor.
*2013-12-20: New additional indication and a new dosage for the treatment of unresectable pancreatic cancer.
==Also known as==
*Generic name: irinotecan hydrochloride trihydrote
*Code names: Camptothecin-11, CPT-11, U-101440E
*Brand names: Axinotecan, Biotecan, Biskam, Campto, Campostar, Camptosar, Elinatecan, Everecan, Faultenocan, Irenax, Irinogen, Irinomedac, Irinotel, Irinotesin, Irnocam, Itoxaril, Linatecan, Satigene, Tecnotecan, Tekamen, Toptecin, Trinotecan, Winol
==References==
Category:Drugs
Category:Intravenous medications
Category:Irritant
Category:Topoisomerase I inhibitors
Category:Carcinoma of unknown primary medications 
Category:Anaplastic glioma medications 
Category:Cervical cancer medications
Category:Colorectal cancer medications
Category:Esophageal adenocarcinoma medications
Category:Esophageal cancer medications
Category:Esophageal squamous cell carcinoma medications
Category:Ewing sarcoma medications
Category:Gallbladder cancer medications
Category:Gastric cancer medications
Category:Glioblastoma medications
Category:Hepatoblastoma medications
Category:Neuroblastoma medications
Category:Neuroendocrine carcinoma medications
Category:Non-small cell lung cancer medications
Category:Pancreatic cancer medications 
Category:Penile cancer medications
Category:Rectal cancer medications
Category:Rhabdomyosarcoma medications
Category:Small cell lung cancer medications
Category:FDA approved in 1996
Category:EMA approved in 1995
Category:WHO Essential Cancer Medicine