Oral versus intravenous fluoropyrimidines for colorectal cancer

Oral Tegafur-Uracil Combination plus Leucovorin versus Other Fluoropyrimidine Agents in Colorectal Cancer: A Systematic Review and Meta-Analysis

“…One of the reasons could be because of the heterogeneity in the included studies. Contrary to the results of our study, the Cochrane analysis 16 which included 24 trials showed a 6% PFS advantage in favor of the intravenous 5-FU group. However, in comparison to our study, one needs to consider the significant heterogeneity in the study design and the differences in the oral fluoropyrimidines that were used in the included studies.…”

“…Our study revealed that OS is comparable between UFT/LV and other fluoropyrimidines, in both early (HR 1.04; 95% CI 0.88-1.23; p ¼ 0.63) and advanced CRC patients (HR 1.02; 95% CI 0.97-1.06; p ¼ 0.42). The Cochrane meta-analysis 16 findings are consistent with our study results. For curative intent studies, the OS HR was 0.92 (95% CI 0.84-1.00), and for the palliative intent studies, the OS HR was 1.02 (95% CI 0.99-1.05).…”

“…This condition is debilitating as it results in increased hospitalization days 40 and patients usually present with redness, edema, and ulceration of the gastrointestinal tract leading to decreased intake and ingestion of oral foods and would require parenteral nutritional support. Further, it is noteworthy to mention that in previous reviews 15,16 UFT/LV was associated with an increase in hand-foot-mouth syndrome, which was not found in our analysis. 16 Although UFT/LV demonstrates superiority in adverse event profile compared with other fluoropyrimidines, we need to factor in the clinical heterogeneity in dosage, consider the dietary folate intake and genetic polymorphism between individuals, and interpret the results accordingly.…”

“…Further, it is noteworthy to mention that in previous reviews 15,16 UFT/LV was associated with an increase in hand-foot-mouth syndrome, which was not found in our analysis. 16 Although UFT/LV demonstrates superiority in adverse event profile compared with other fluoropyrimidines, we need to factor in the clinical heterogeneity in dosage, consider the dietary folate intake and genetic polymorphism between individuals, and interpret the results accordingly. Nonetheless, it is reasonable to conclude that UFT/LV has a superior safety and tolerability profile compared with other fluoropyrimidines.…”

Oral Tegafur-Uracil Combination plus Leucovorin versus Other Fluoropyrimidine Agents in Colorectal Cancer: A Systematic Review and Meta-Analysis

“…One of the reasons could be because of the heterogeneity in the included studies. Contrary to the results of our study, the Cochrane analysis 16 which included 24 trials showed a 6% PFS advantage in favor of the intravenous 5-FU group. However, in comparison to our study, one needs to consider the significant heterogeneity in the study design and the differences in the oral fluoropyrimidines that were used in the included studies.…”

“…Our study revealed that OS is comparable between UFT/LV and other fluoropyrimidines, in both early (HR 1.04; 95% CI 0.88-1.23; p ¼ 0.63) and advanced CRC patients (HR 1.02; 95% CI 0.97-1.06; p ¼ 0.42). The Cochrane meta-analysis 16 findings are consistent with our study results. For curative intent studies, the OS HR was 0.92 (95% CI 0.84-1.00), and for the palliative intent studies, the OS HR was 1.02 (95% CI 0.99-1.05).…”

“…This condition is debilitating as it results in increased hospitalization days 40 and patients usually present with redness, edema, and ulceration of the gastrointestinal tract leading to decreased intake and ingestion of oral foods and would require parenteral nutritional support. Further, it is noteworthy to mention that in previous reviews 15,16 UFT/LV was associated with an increase in hand-foot-mouth syndrome, which was not found in our analysis. 16 Although UFT/LV demonstrates superiority in adverse event profile compared with other fluoropyrimidines, we need to factor in the clinical heterogeneity in dosage, consider the dietary folate intake and genetic polymorphism between individuals, and interpret the results accordingly.…”

“…Further, it is noteworthy to mention that in previous reviews 15,16 UFT/LV was associated with an increase in hand-foot-mouth syndrome, which was not found in our analysis. 16 Although UFT/LV demonstrates superiority in adverse event profile compared with other fluoropyrimidines, we need to factor in the clinical heterogeneity in dosage, consider the dietary folate intake and genetic polymorphism between individuals, and interpret the results accordingly. Nonetheless, it is reasonable to conclude that UFT/LV has a superior safety and tolerability profile compared with other fluoropyrimidines.…”

A case–control study to assess the ability of the thymine challenge test to predict patients with severe to life threatening fluoropyrimidine‐induced gastrointestinal toxicity

“…Although the data reported in this manuscript are from a small study, where the majority of the patients were treated with capecitabine monotherapy, the cohort appeared to reflect the disposition of fluoropyrimidines observed in numerous larger studies. In particular, the prospective incidence of G3 and G4 GI toxicity was similar to that reported in larger trials . In addition, the prevalence of deleterious DPYD variants, calculated from the prospective patients only, was similar to the expected prevalence in European populations, which was the predominant ancestry reported in the cohort.…”

Oral Tegafur-Uracil Combination plus Leucovorin versus Other Fluoropyrimidine Agents in Colorectal Cancer: A Systematic Review and Meta-Analysis

“…One of the reasons could be because of the heterogeneity in the included studies. Contrary to the results of our study, the Cochrane analysis 16 which included 24 trials showed a 6% PFS advantage in favor of the intravenous 5-FU group. However, in comparison to our study, one needs to consider the significant heterogeneity in the study design and the differences in the oral fluoropyrimidines that were used in the included studies.…”

“…Our study revealed that OS is comparable between UFT/LV and other fluoropyrimidines, in both early (HR 1.04; 95% CI 0.88-1.23; p ¼ 0.63) and advanced CRC patients (HR 1.02; 95% CI 0.97-1.06; p ¼ 0.42). The Cochrane meta-analysis 16 findings are consistent with our study results. For curative intent studies, the OS HR was 0.92 (95% CI 0.84-1.00), and for the palliative intent studies, the OS HR was 1.02 (95% CI 0.99-1.05).…”

“…This condition is debilitating as it results in increased hospitalization days 40 and patients usually present with redness, edema, and ulceration of the gastrointestinal tract leading to decreased intake and ingestion of oral foods and would require parenteral nutritional support. Further, it is noteworthy to mention that in previous reviews 15,16 UFT/LV was associated with an increase in hand-foot-mouth syndrome, which was not found in our analysis. 16 Although UFT/LV demonstrates superiority in adverse event profile compared with other fluoropyrimidines, we need to factor in the clinical heterogeneity in dosage, consider the dietary folate intake and genetic polymorphism between individuals, and interpret the results accordingly.…”

“…Further, it is noteworthy to mention that in previous reviews 15,16 UFT/LV was associated with an increase in hand-foot-mouth syndrome, which was not found in our analysis. 16 Although UFT/LV demonstrates superiority in adverse event profile compared with other fluoropyrimidines, we need to factor in the clinical heterogeneity in dosage, consider the dietary folate intake and genetic polymorphism between individuals, and interpret the results accordingly. Nonetheless, it is reasonable to conclude that UFT/LV has a superior safety and tolerability profile compared with other fluoropyrimidines.…”

A case–control study to assess the ability of the thymine challenge test to predict patients with severe to life threatening fluoropyrimidine‐induced gastrointestinal toxicity

“…Although the data reported in this manuscript are from a small study, where the majority of the patients were treated with capecitabine monotherapy, the cohort appeared to reflect the disposition of fluoropyrimidines observed in numerous larger studies. In particular, the prospective incidence of G3 and G4 GI toxicity was similar to that reported in larger trials . In addition, the prevalence of deleterious DPYD variants, calculated from the prospective patients only, was similar to the expected prevalence in European populations, which was the predominant ancestry reported in the cohort.…”

Oral Tegafur-Uracil Combination plus Leucovorin versus Other Fluoropyrimidine Agents in Colorectal Cancer: A Systematic Review and Meta-Analysis

“…One of the reasons could be because of the heterogeneity in the included studies. Contrary to the results of our study, the Cochrane analysis 16 which included 24 trials showed a 6% PFS advantage in favor of the intravenous 5-FU group. However, in comparison to our study, one needs to consider the significant heterogeneity in the study design and the differences in the oral fluoropyrimidines that were used in the included studies.…”

“…Our study revealed that OS is comparable between UFT/LV and other fluoropyrimidines, in both early (HR 1.04; 95% CI 0.88-1.23; p ¼ 0.63) and advanced CRC patients (HR 1.02; 95% CI 0.97-1.06; p ¼ 0.42). The Cochrane meta-analysis 16 findings are consistent with our study results. For curative intent studies, the OS HR was 0.92 (95% CI 0.84-1.00), and for the palliative intent studies, the OS HR was 1.02 (95% CI 0.99-1.05).…”

“…This condition is debilitating as it results in increased hospitalization days 40 and patients usually present with redness, edema, and ulceration of the gastrointestinal tract leading to decreased intake and ingestion of oral foods and would require parenteral nutritional support. Further, it is noteworthy to mention that in previous reviews 15,16 UFT/LV was associated with an increase in hand-foot-mouth syndrome, which was not found in our analysis. 16 Although UFT/LV demonstrates superiority in adverse event profile compared with other fluoropyrimidines, we need to factor in the clinical heterogeneity in dosage, consider the dietary folate intake and genetic polymorphism between individuals, and interpret the results accordingly.…”

“…Further, it is noteworthy to mention that in previous reviews 15,16 UFT/LV was associated with an increase in hand-foot-mouth syndrome, which was not found in our analysis. 16 Although UFT/LV demonstrates superiority in adverse event profile compared with other fluoropyrimidines, we need to factor in the clinical heterogeneity in dosage, consider the dietary folate intake and genetic polymorphism between individuals, and interpret the results accordingly. Nonetheless, it is reasonable to conclude that UFT/LV has a superior safety and tolerability profile compared with other fluoropyrimidines.…”

A case–control study to assess the ability of the thymine challenge test to predict patients with severe to life threatening fluoropyrimidine‐induced gastrointestinal toxicity

“…Although the data reported in this manuscript are from a small study, where the majority of the patients were treated with capecitabine monotherapy, the cohort appeared to reflect the disposition of fluoropyrimidines observed in numerous larger studies. In particular, the prospective incidence of G3 and G4 GI toxicity was similar to that reported in larger trials . In addition, the prevalence of deleterious DPYD variants, calculated from the prospective patients only, was similar to the expected prevalence in European populations, which was the predominant ancestry reported in the cohort.…”