Latest research on Capecitabine

Capecitabine is an orally-administered chemotherapeutic agent used in the treatment of metastatic breast and colorectal cancers. Capecitabine is a prodrug, that is enzymatically converted to fluorouracil (antimetabolite) in the tumor, where it inhibits DNA synthesis and slows growth of tumor tissue.

Latest findings

TTP was, however, significantly inferior with UFT plus LV compared to the Mayo Clinic regimen and recalculating published data (Benner, 1999) using the study arm as the denominator in line with the Capecitabine study, the hazard ratio was 1.22 (P=0.01). [source, 2002]
In summary, the infusional regimens produced significant improvements in TTP, whereas UFT plus LV produced a significantly inferior TTP; oral Capecitabine and the de Gramont regimen resulted in significant improvements in response rates. [source, 2002]
In terms of overall incidence, Capecitabine caused significantly less diarrhoea, nausea, stomatitis and alopecia compared with the Mayo Clinic regimen (Hoff ; Van Cutsem ) and UFT plus LV significantly less diarrhoea, neutropenia, nausea/vomiting and stomatitis/mucositis (Pazdur ). [source, 2002]
With the exception of Capecitabine, there was a trend towards a higher incidence of grade 3 or 4 nausea and vomiting with the new regimens in all trials. [source, 2002]
No significant difference in the incidence of grade 3 or 4 diarrhoea was observed with Capecitabine compared with the Mayo Clinic regimen. [source, 2002]
Hand–foot syndrome, a cutaneous condition affecting palms and soles, is one of the more common adverse effects of Capecitabine, but is usually mild or moderate in intensity. [source, 2002]
In the Capecitabine trial, only two out of the 596 patients included in the safety analysis were hospitalised because of this adverse effect (one patient required an 8-h stay and one needed overnight observation). [source, 2002]
Given that patients are reluctant to sacrifice efficacy for convenience, the fact that Capecitabine produced superior response rates and equivalent TTP compared with the Mayo Clinic regimen, while UFT plus LV produced lower response rates and inferior TTP, is relevant when considering treatment options. [source, 2002]
By contrast, no clinically relevant differences in the pharmacokinetics of Capecitabine and its metabolites were observed in patients taking Capecitabine under fasting conditions or after a standard meal (Reigner ). [source, 2002]
It is recommended that Capecitabine be administered twice daily within 30 min after breakfast and an evening meal with water to mimic the clinical trials, but this should cause little if any disruption to patients' lifestyles. [source, 2002]