Fluoropyrimidines in the treatment of advanced neoplastic diseases: role and advantages of UFT.
The fluoropyrimidine antimetabolites were employed in a wide range of neoplastic diseases. In particular, 5-fluorouracil in association with other chemotherapeutic agents, or biochemical modulators was successfully used in the treatment of colorectal, gastric, breast, head and neck cancers. With this type of chemotherapy, a response rate < or = 20% was obtained in gastrointestinal tumors, without a statistically significant impact on the overall survival. UFT is a combination of tegafur an uracil, which has the important advantage of an improved oral bioavailability, if we compare it with 5-fluorouracil. Uracil, avoiding the fluoropyrimidine degradation inside the tumor cells, increases the permanence of the metabolically active fluoropyrimidine into the target cell, so having an improvement in the therapeutic activity. A very large spectrum of cancers were treated with this molecule. In particular, a response rate in the range of 20-40% was observed in the treatment of patients with metastatic colorectal cancer. Phase III trials are ongoing to evaluate the advantage on 5-FU of this new fluoropyrimidine in terms of clinical efficacy, and quality of life, considering the possibility to administer it orally.
Del Vecchio
M
M
Division of Medical Oncology B, Istituto Nazionale per lo Studio e la Cura dei Tumori, Milan, Italy.
Procopio
G
G
Cassata
A
A
Pozzi
P
P
Busto
G
G
Celio
L
L
Bajetta
E
E
D000818:Animals; D000964:Antimetabolites, Antineoplastic / Q000009:adverse effects / Q000493:pharmacokinetics / Q000494:pharmacology*; D001682:Biological Availability; D000069287:Capecitabine; D003841:Deoxycytidine / Q000031:analogs & derivatives / Q000494:pharmacology; D005467:Floxuridine / Q000494:pharmacology; D005472:Fluorouracil / Q000031:analogs & derivatives; D006801:Humans; D009369:Neoplasms / Q000188:drug therapy*; D011799:Quinazolines / Q000494:pharmacology; D013876:Thiophenes / Q000494:pharmacology; D014498:Uracil / Q000494:pharmacology
D000964:Antimetabolites, Antineoplastic; D011799:Quinazolines; D013876:Thiophenes; D005467:Floxuridine; D003841:Deoxycytidine; D014498:Uracil; D000069287:Capecitabine; C068874:raltitrexed; D005472:Fluorouracil; C025034:doxifluridine