Capecitabine versus continuous-infusion 5-fluorouracil for colorectal cancer: a retrospective efficacy and safety comparison.
For more than 40 years, 5-fluorouracil (5-FU) has been considered the most effective systemic agent for managing advanced colorectal cancer. However, continuous-infusion (CI) schedules of 5-FU require central venous access devices, which are associated with catheter complications and are an inconvenience to patients. The novel oral fluoropyrimidine capecitabine appears to offer comparable efficacy while providing a more convenient schedule that is often preferred by patients. Published phase II/III clinical studies of capecitabine-based regimens for colorectal cancer were compared with key studies of CI 5-FU-based regimens to assess safety, efficacy, quality of life, and pharmacoeconomics. Studies were identified via Medline searches and conference abstracts dating back to 1997. Qualitative analyses show that capecitabine as a single agent as well as in combination regimens is an effective first-line treatment for metastatic colorectal cancer, providing a higher response rate compared with standard 5-FU/leucovorin. Costs associated with capecitabine also appear to be lower than those associated with catheter-based therapies. Capecitabine offers physicians a more convenient treatment for advanced colorectal cancer, with manageable toxicity and antitumor activity comparable to that of CI therapies.
Saif
M Wasif
MW
Section of Medical Oncology, Yale University School of Medicine, 333 Cedar St., FMP 116, New Haven, CT 06520, USA. wasif.saif@yale.edu
D000284:Administration, Oral; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D000069287:Capecitabine; D015179:Colorectal Neoplasms / Q000188:drug therapy*; D003841:Deoxycytidine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007262:Infusions, Intravenous; D011788:Quality of Life; D012189:Retrospective Studies; D016896:Treatment Outcome
D000964:Antimetabolites, Antineoplastic; D003841:Deoxycytidine; D000069287:Capecitabine; D005472:Fluorouracil