TORCIRIN 100 mg contains Irinotecan, a chemotherapeutic agent that plays a critical role in the management of certain cancers. As a topoisomerase I inhibitor, it has proven efficacy, particularly in the treatment of metastatic colorectal cancer. Its action directly targets the replication machinery of cancer cells, making it a cornerstone in cancer chemotherapy regimens.

Irinotecan is administered via intravenous infusion, usually over 30 to 90 minutes, in cycles determined by the oncologist based on the type and stage of cancer, as well as patient tolerance.

At the cellular level, Irinotecan is converted in the liver to its active metabolite SN-38, which is significantly more potent. This metabolite binds to the topoisomerase I-DNA complex, preventing the re-ligation of single-strand breaks in DNA. This disruption leads to DNA damage during replication, ultimately triggering cell death. Since cancer cells divide more rapidly than normal cells, they are more susceptible to this mechanism, although some normal fast-dividing cells (like those in the gut or hair follicles) are also affected, leading to side effects.

TORCIRIN (Irinotecan) is primarily indicated for the treatment of:

• Metastatic colorectal cancer (mCRC), either alone or in combination with other agents such as fluorouracil and leucovorin.

• It is typically used after failure of initial therapy or as a first-line treatment in specific combinations.

In some cases, based on emerging clinical evidence and oncologist discretion, Irinotecan may be employed off-label in the treatment of other solid tumors.

Adverse Side Effects

While Irinotecan is effective in impeding cancer progression, it also impacts healthy rapidly dividing cells, leading to a range of side effects. These can vary in intensity from patient to patient.

Gastrointestinal Toxicity

• Diarrhea is the hallmark side effect, occurring in two forms:

  • Early-onset diarrhea (within 24 hours), often accompanied by abdominal cramping, linked to cholinergic effects. It typically responds to atropine.

  • Late-onset diarrhea (after 24 hours), which can be severe and prolonged, requiring prompt management with high-dose loperamide to prevent dehydration and complications.

Hematological Effects

• Neutropenia (low white blood cells), increasing infection risk.

• Anemia (low red blood cells), potentially causing fatigue and weakness.

• Thrombocytopenia (low platelets), which can lead to easy bruising and bleeding.

Other Notable Side Effects

• Nausea and vomiting, often managed with prophylactic antiemetics.

• Alopecia (hair loss), usually temporary.

• Fatigue, sometimes profound, affecting daily activities.

• Mouth sores (mucositis), necessitating gentle oral care.