5-Fluorouracil can cross brain-blood barrier and cause encephalopathy: should we expect the same from capecitabine? A case report on capecitabine-induced central neurotoxicity progressing to coma.
OBJECTIVE
Capecitabine is a relatively new oral fluoropyrimidine currently licensed for the treatment of colorectal and breast cancer.


RESULTS
It has the advantage of oral administration with good tolerability and comparable activity to intravenous 5-fluorouracil. Central neurotoxicity has been described in 5-fluorouracil-treated patients but there is little data regarding capecitabine. We report here a case of reversible capecitabine-induced encephalopathy progressing to coma.


CONCLUSIONS
Literature on fluoropyrimidine-related neurotoxicity will also be reviewed and possible mechanisms of the drug or its metabolites crossing the blood-brain barrier will be discussed.
Formica
V
V
Department of Medicine, Royal Marsden Hospital, Sutton, Surrey SM2 5PT, UK.
Leary
A
A
Cunningham
D
D
Chua
Y J
YJ
D000970:Antineoplastic Agents / Q000009:adverse effects / Q000493:pharmacokinetics*; D001812:Blood-Brain Barrier; D000069287:Capecitabine; D002493:Central Nervous System Diseases / Q000139:chemically induced*; D003128:Coma / Q000139:chemically induced*; D003841:Deoxycytidine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000493:pharmacokinetics; D005472:Fluorouracil / Q000009:adverse effects / Q000493:pharmacokinetics*; D006801:Humans
D000970:Antineoplastic Agents; D003841:Deoxycytidine; D000069287:Capecitabine; D005472:Fluorouracil