Overview of the changing paradigm in cancer treatment: oral chemotherapy.
OBJECTIVE
Several new oral chemotherapeutic agents have recently been introduced. Many possess novel mechanisms of action and specific targets that result in different adverse effect profiles from those associated with traditional chemotherapies and hormonal therapies. The potential advantages and challenges associated with oral chemotherapy are discussed.


CONCLUSIONS
Use of the oral route is convenient and allows administration to take place at home or in non-traditional settings. However, nausea, difficulty swallowing, patient nonadherence, interactions with drugs and food, other pharmacokinetic factors, and the high cost of treatment can present problems in using these agents by the oral route. Awareness by clinicians of the potential problems with oral chemotherapy can help to avoid or minimize problems that might affect patient outcomes.


CONCLUSIONS
While bioavailability studies are often an integral part of developing oral agents, their comparisons with parenteral forms are less well documented. However, studies comparing intravenous 5-fluorouracil (5-FU) with oral 5-FU prodrugs have demonstrated that efficacy, safety, and quality of life are not compromised by the use of oral therapy. Finally, these studies, as well as others, reveal patients prefer the oral route of administration.
Aisner
Joseph
J
University of Medicine and Dentistry of New Jersey , Robert Wood Johnson Medical School, New Brunswick, NJ 08903-2681, USA. desouzbe@umdnj.edu
D000284:Administration, Oral; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use; D001682:Biological Availability; D006801:Humans; D007263:Infusions, Parenteral; D009369:Neoplasms / Q000188:drug therapy*; D010349:Patient Compliance; D017060:Patient Satisfaction; D011788:Quality of Life; D012646:Self Administration / Q000639:trends
D000970:Antineoplastic Agents