title: Capecitabine chemotherapy for metastatic colorectal cancer. Chemical structure, combinations and efficacy.
abstract: OBJECTIVE
  capecitabine is an oral fluoropyrimidine which had been developed as a pro-drug of fluorouracil (FU), and had shown improved tolerability and intratumor drug concentrations through its tumor-specific conversion to the active drug. Our purpose was to make a comprehensive literature review regarding capecitabine's efficacy in metastatic colorectal cancer.
  
  
  METHODS
  we searched the Pubmed and Cochrane databases regarding all available information on capecitabine, focusing on its clinical effectiveness against metastatic colorectal cancer. Special attention was paid on trials that compared capecitabine with standard folinic acid (leucovorin/ LV)-modulated intravenous 5-fluorouracil (5-FU) bolus regimens in patients with metastatic colorectal cancer. Moreover, the efficacy of capecitabine alone or in several combinations with other active drugs such as irinotecan and oxaliplatin on metastatic colorectal cancer were also assessed.
  
  
  RESULTS
  comparative trials showed that capecitabine is at least equivalent to standard 5-FU/LV combination regarding progression-free and overall survival, expressing at the same time a better tolerability profile with a much lower incidence of stomatitis.
  
  
  CONCLUSIONS
  nowadays it is known that capecitabine can be combined with other active drugs such as irinotecan and oxaliplatin and the combination of oxaliplatin with capecitabine represents a new standard of care for metastatic colorectal cancer.
authors.affiliation: Saint Savvas Anticancer Institute of Athens, 2nd Department of Radiation Therapy, Athens, Greece. gkoyokoyrakis@yahoo.gr
authors.forename: G
authors.initials: G
authors.lastname: Koukourakis
authors.forename: V
authors.initials: V
authors.lastname: Kouloulias
authors.forename: G
authors.initials: G
authors.lastname: Zacharias
authors.forename: M
authors.initials: M
authors.lastname: Koukourakis
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D000069287:Capecitabine; D002986:Clinical Trials as Topic; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000556:secondary*; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D005472:Fluorouracil / Q000008:administration & dosage / Q000031:analogs & derivatives; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage; D015394:Molecular Structure; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D003841:Deoxycytidine; D000069287:Capecitabine; D002955:Leucovorin; D005472:Fluorouracil