Efficacy of the oral fluorouracil pro-drug capecitabine in cancer treatment: a review.
Capecitabine (Xeloda) was developed as a pro-drug of fluorouracil (FU), with the aim of improving tolerability and intratumor drug concentrations through its tumorspecific conversion to the active drug. The purpose of this paper is to review the available information on capecitabine, focusing on its clinical effectiveness against various carcinomas. Identification of all eligible English trails was made by searching the PubMed and Cochrane databases from 1980 to 2007. Search terms included capecitabine, Xeloda and cancer treatment. Nowadays, FDA has approved the use of capecitabine as a first line therapy in patients with metastatic colorectal cancer when single-agent fluoropyrimidine is preferred. The drug is also approved for use as a single agent in metastatic breast cancer patients who are resistant to both anthracycline and paclitaxel-based regimens or when further anthracycline treatment is contraindicated. It is also approved in combination with docetaxel after failure of prior anthracycline-based chemotherapy. In patients with prostate, pancreatic, renal cell and ovarian carcinomas, capecitabine as a single-agent or in combination with other drugs has also shown benefits. Improved tolerability and comparable efficacy, compared with the intravenous FU/LV combination, in addition to its oral administration, make capecitabine an attractive option for the treatment of several types of carcinomas.
Koukourakis
Georgios V
GV
Attikon University Hospital of Athens, 2nd Radiology Department, Radiation Therapy Unit, Medical School of Athens, Greece. gkoyokoyrakis@yahoo.gr.
Kouloulias
Vassilios
V
Koukourakis
Michael J
MJ
Zacharias
Georgios A
GA
Zabatis
Haralabos
H
Kouvaris
John
J
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D000069287:Capecitabine; D003841:Deoxycytidine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000493:pharmacokinetics / Q000627:therapeutic use; D005472:Fluorouracil / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000493:pharmacokinetics / Q000627:therapeutic use; D006801:Humans; D009369:Neoplasms / Q000188:drug therapy* / Q000401:mortality; D011355:Prodrugs; D016896:Treatment Outcome
D011355:Prodrugs; D003841:Deoxycytidine; D000069287:Capecitabine; D005472:Fluorouracil
Urol Oncol. 2006 Nov-Dec;24(6):487-91
17138128
Am J Clin Oncol. 2007 Feb;30(1):78-81
17278899
Oncology. 2007;73(3-4):169-76
18418009
Eur J Cancer. 1998 Jul;34(8):1274-81
9849491
Int J Radiat Oncol Biol Phys. 2005 Oct 1;63(2):346-53
15913913
Ann Oncol. 2006 Feb;17(2):246-51
16282246
Eur J Cancer. 2004 Mar;40(4):536-42
14962720
J Clin Oncol. 1994 Jun;12(6):1291-5
8201391
Invest New Drugs. 2000 Nov;18(4):343-54
11081570
Ann Oncol. 2003 Jan;14(1):97-104
12488300
Ann Oncol. 2001 Sep;12(9):1247-54
11697835
Am J Kidney Dis. 2002 Jan;39(1):48-54
11774101
J Clin Oncol. 1999 Feb;17(2):485-93
10080589
Br J Cancer. 2002 May 6;86(9):1465-71
11986782
Cancer. 2001 Oct 1;92(7):1759-68
11745247
Clin Cancer Res. 1998 Apr;4(4):1013-9
9563897
Biol Pharm Bull. 1998 Jul;21(7):713-7
9703255
Cancer J. 2007 Jul-Aug;13(4):247-56
17762760
J Clin Oncol. 2004 Jun 1;22(11):2214-32
15169811
J Clin Oncol. 2004 Jun 15;22(12):2321-7
15197193
J Clin Oncol. 1998 Jan;16(1):301-8
9440757
Ann Oncol. 2008 Feb;19(2):340-7
17962204
Pancreas. 2004 Apr;28(3):301-4
15084976
Gynecol Oncol. 2004 May;93(2):417-21
15099955
J Clin Oncol. 2001 Apr 15;19(8):2282-92
11304782
Cancer. 2004 Apr 15;100(8):1558-77
15073842
Br J Cancer. 2007 Mar 26;96(6):912-7
17325705
Cancer. 2004 Feb 1;100(3):531-7
14745869
Br J Cancer. 2004 May 4;90(9):1740-6
15150624
Ann Oncol. 2005 Dec;16(12):1898-905
16219623
J Clin Oncol. 2004 Jun 1;22(11):2084-91
15169795
J Clin Oncol. 2002 Apr 1;20(7):1759-66
11919232
J Clin Oncol. 2005 Aug 20;23(24):5620-7
16009958
N Engl J Med. 2006 Sep 14;355(11):1114-23
16971718
Cancer. 2004 Jan 15;100(2):279-87
14716761
Ann Oncol. 2003 Sep;14(9):1378-82
12954576
Urol Oncol. 2004 Sep-Oct;22(5):387-92
15464918
Br J Cancer. 2000 Sep;83(5):583-7
10944596
Br J Cancer. 2004 Apr 5;90(7):1312-7
15054447
Clin Colorectal Cancer. 2005 May;5(1):50-6
15929806
Croat Med J. 2006 Oct;47(5):693-700
17042060
Am J Clin Oncol. 2007 Aug;30(4):340-5
17762432
J Korean Med Sci. 2006 Feb;21(1):52-7
16479065
J Clin Oncol. 2000 Mar;18(6):1337-45
10715306
J Clin Oncol. 2003 Jan 1;21(1):66-8
12506172
Acta Oncol. 2004;43(2):186-9
15163168
J Clin Oncol. 2002 Jan 1;20(1):160-4
11773165
Eur J Cancer (1965). 1980 Apr;16(4):427-32
6447071
J Clin Oncol. 1998 May;16(5):1795-802
9586893
Int J Radiat Oncol Biol Phys. 2006 Nov 1;66(3):762-71
17011451
Anticancer Res. 2007 Jan-Feb;27(1B):541-5
17348439
Ann Oncol. 2003 Aug;14(8):1227-33
12881384
Br J Cancer. 2002 May 6;86(9):1367-72
11986765
J Natl Cancer Inst. 2000 Feb 2;92(3):205-16
10655437
Ann Oncol. 2004 Feb;15(2):224-9
14760113
Cancer. 1992 Aug 15;70(4 Suppl):998-1002
1638471
J Clin Oncol. 2006 Oct 1;24(28):4620-5
17008704
J Clin Oncol. 2002 Jun 15;20(12):2812-23
12065558
Br J Cancer. 2003 Nov 17;89(10):1843-8
14612890
J Clin Oncol. 2001 Nov 1;19(21):4097-106
11689577
Eur J Cancer. 1993;29A(12):1658-63
8398289
Int J Oncol. 2003 May;22(5):961-7
12684660