Capecitabine: nursing implications of a new oral chemotherapeutic agent.
OBJECTIVE
To describe the new oral chemotherapeutic agent capecitabine (Xeloda, Roche Laboratories Inc., Nutley, NJ) and key concepts driving its development and to delineate the nursing impact of patient-administered, home-based chemotherapies.


METHODS
Published papers, investigational materials, package inserts, and clinical experience.


RESULTS
Capecitabine recently was approved to treat metastatic breast cancer refractory to paclitaxel and anthracycline-containing regimens. Efficacy has been demonstrated. However, although the current regimen is well-tolerated, > or = 40% of patients require dose modification because of grade 2 or greater toxicity, usually hand-foot syndrome or gastrointestinal symptoms.


CONCLUSIONS
Capecitabine frees nurses from infusion-related workload, allowing and demanding a new type and level of patient education. Such education emphasizes compliance with the treatment plan and prevention, timely recognition, and management of toxicities. These practice changes also challenge nurses to advocate for reimbursement of educational practices.


CONCLUSIONS
Oncology nurses will play more of a central role as use of patient-administered, home-based therapies increases. Nurses must enhance their patient-education and telephone symptom-management skills and help to secure reimbursement for such activities.
Mrozek-Orlowski
M E
ME
Comprehensive Breast Care Program, Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA.
Frye
D K
DK
Sanborn
H M
HM
D000284:Administration, Oral; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000069287:Capecitabine; D003841:Deoxycytidine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005472:Fluorouracil / Q000031:analogs & derivatives; D006801:Humans; D009369:Neoplasms / Q000188:drug therapy / Q000451:nursing*; D009732:Nursing Care; D009859:Oncology Nursing; D010353:Patient Education as Topic
D000970:Antineoplastic Agents; D003841:Deoxycytidine; D000069287:Capecitabine; D005472:Fluorouracil