Medical resource use in a phase III trial (SO 14796) of XelodaTM (capecitabine) in previously untreated advanced/metastatic colorectal cancer

Twelves, Chris; Cutsem, Éric Van; Hieke, K; Barker, Charlotte I. S.; Jamieson, Carol; Hornberger, John; Garrison, LP; Osterwalder, B; Thibault, Alain

doi:10.1016/s0959-8049(99)80640-6

Cited by 21 publications

(28 citation statements)

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“…5FU/LV ("Mayo"), in terms of efficacy as well as quality of life and pharmacoeconomic resource parameters. Early results, reported so far only in abstract form, show higher response rates (26.6% versus 17.9%, p = 0.013 [48], and 23.2% versus 15.5%, p = 0.02 [49]) and a more favorable toxicity profile than modulated bolus 5-FU [48,49]. The same regimen of capecitabine is also being evaluated in a large-scale adjuvant trial, which is expected to recruit approximately 1,700 Duke's C colon cancer patients (X-ACT study).…”

Section: Capecitabinementioning

confidence: 86%

The Use of Thymidylate Synthase Inhibitors in the Treatment of Advanced Colorectal Cancer: Current Status

Papamichael¹

2000

STEM CELLS

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The combination of 5-fluorouracil (5-FU) and leucovorin has been the unofficial "standard" therapy for patients with colorectal cancer for over a decade. Recently, however, a number of new agents targeted against the enzyme thymidylate synthase have been synthesized and are in various stages of development. The currently available thymidylate synthase inhibitors are discussed.Enormous efforts have been made over the years to improve the efficacy of 5-FU, the most popular of these agents. Biochemical modulation by leucovorin has been the most successful so far. Continuous infusion schedules also appear to be advantageous over bolus administration. However, marked intra-and interpatient variability, combined with nonlinear elimination kinetics and erratic oral bioavailability are relative limitations to further development of 5-FU. New oral 5-FU prodrugs such as UFT, S-1, and Capecitabine may help to overcome some of these difficulties. Eniluracil, a potent inhibitor of the enzyme dihydropyrimidine dehydrogenase, may also help by overcoming potential 5-FU resistance mechanisms, in addition to increasing its bioavailability. Of the antifolate-based inhibitors, Tomudex is in the most advanced stage of development. Similar efficacy with 5-FU and a convenient schedule may suggest a role in future combination regimens.It is quite likely that even the most optimal thymidylate synthase inhibition will have limitations in terms of clinical efficacy. Novel combinations of 5-FU or its analogs with agents that have different mechanisms of action (e.g., oxaliplatin, irinotecan) could provide important new opportunities for improving the outlook of patients with colorectal cancer.

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Section: Capecitabinementioning

confidence: 86%

The Use of Thymidylate Synthase Inhibitors in the Treatment of Advanced Colorectal Cancer: Current Status

Papamichael¹

2000

STEM CELLS

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“…Each of these large trials included more than 600 patients. In the trial conducted in 61 centers in the USA, Brazil, Canada, and Mexico, a total of 605 patients were randomized to receive either 2500 mg/m 2 per day capecitabine in divided daily doses for 14 d followed by 7 days' rest or the Mayo regimen described above [32,33] . Capecitabine was more active than 5-FU in the induction of a tumor response, and the two groups showed similar times to tumor response and response durations.…”

Section: Capecitabinementioning

confidence: 99%

Role of chemotherapy and novel biological agents in the treatment of elderly patients with colorectal cancer

Rosati¹,

Bilancia²

2008

WJG

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Patients older than 65 years are the fastest growing segment of the cancer population. It is estimated that within 20 years over 75% of cases and 85% of deaths from colorectal cancer (CRC) will be in this setting. Concerns about cancer treatment in the elderly relate to comorbidities, which increase proportionally with age, physiological changes associated with aging which may influence drug metabolism and toxicity, and diminishing life expectancy, which particularly impacts decisions surrounding the benefits of adjuvant therapies. Over the last 10 years, significant improvements in the treatment of advanced CRC with combination therapy have been made. The randomized trials which have defined these improvements did not exclude elderly patients. However, the median age of patients in these trials has generally been approximately 60 years. Thus, it appears that some degree of selection is involved with younger and presumably fitter patients being the subjects in most of the pivotal trials. The availability of new molecularly targeted agents and newly improved existing agents has expanded the range of treatment options available. This variety gives greater flexibility in dealing with different subsets of patients, such as the elderly. However, some fit elderly patients seem to tolerate combination therapy reasonably well, while studies on unfit elderly subjects are needed.

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“…Median time to progression was 30 weeks with the optimal schedule of 2510 mg m Ϫ2 day Ϫ1 given intermittently. Capecitabine has also been evaluated in two randomized, controlled trials (Table 2) (Cox et al, 1999;Twelves et al, 1999). The Mayo regimen was also selected as the control arm in these studies.…”

Section: Reviewmentioning

confidence: 99%

The changing face of chemotherapy in colorectal cancer

Waters

Cunningham

2001

Br J Cancer

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Cytotoxic chemotherapy for colorectal cancer has undergone a period of dramatic development over the course of the last 5 years. Four distinct classes of drug with activity in this disease are now available, and the current challenge is to establish the best way to use these agents, either in sequence or in combination, for the benefit of patients. This review aims to summarize the data relating to the newer agents and to propose directions for future research.

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Medical resource use in a phase III trial (SO 14796) of XelodaTM (capecitabine) in previously untreated advanced/metastatic colorectal cancer

Cited by 21 publications

References 0 publications

The Use of Thymidylate Synthase Inhibitors in the Treatment of Advanced Colorectal Cancer: Current Status

The Use of Thymidylate Synthase Inhibitors in the Treatment of Advanced Colorectal Cancer: Current Status

Role of chemotherapy and novel biological agents in the treatment of elderly patients with colorectal cancer

The changing face of chemotherapy in colorectal cancer

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