The Role of Capecitabine in the Management of Tumors of the Digestive System

Abstract

Capecitabine has been developed as a prodrug of FU, with the goal of improving tolerability and intratumor drug concentration through tumor-specific conversion to the active drug. The purpose of this article is to review the available information on capecitabine with respect to clinical efficacy for tumors of the digestive tract, adverse-effect profile, documented drug interactions, dosage and administration, and future directions of ongoing research. Relevant English-language literature was identified through searches of NCI, PubMed, ASCO.org and ESMO, ECCO meetings proceedings.

Efficacy and safety of capecitabine in combination with docetaxel and mitomycin C in patients with pre-treated pancreatic, gallbladder, and bile duct carcinoma

“…However, firstline treatment in pancreatic and biliary tract cancer is frequently gemcitabine based. 5-FU and especially its oral derivative capecitabine are active in pancreatic as well as in biliary tract cancers and may thus represent an alternative for second line treatment (Gennatas et al 2009;Patt et al 2004).…”

A phase I dose escalation study of a pharmacobiologically based scheduling of capecitabine and mitomycin C in patients with gastrointestinal malignancies

“…Mitomycin C (MMC) and capecitabine have shown evidence of activity in a variety of gastrointestinal malignancies [4, 5, 14]. Preclinical as well as clinical studies have suggested that MMC produces significant upregulation of tumor specific levels of TP starting 4–6 days after treatment and persisting for at least 10 days [16, 17].…”

“…Due to the preferential expression in tumor tissues of the rate-limiting enzyme TP in converting capecitabine to 5-FU, capecitabine has been shown to have a superior therapeutic index to 5-FU in preclinical studies [13]. Capecitabine has widespread activity in most if not all GI malignancies as shown by multiple studies using it either as a single agent or in combination with other agents [14]. …”

Personalised, Rational, Efficacy-Driven Cancer Drug Dosing via an Artificial Intelligence SystEm (PRECISE): A Protocol for the PRECISE CURATE.AI Pilot Clinical Trial

“…We chose capecitabine-containing regimens (XELOX, XELIRI and single-agent capecitabine) as capecitabine is one of the most commonly used drugs for a wide range of GI and other solid tumours ( 36 ), which facilitates recruitment. In addition, it is generally accepted that the MTD for capecitabine is not well-tolerated in a large proportion of patients ( 37 , 38 ), with guidelines recommending a starting dose lower than the MTD ( 39 ).…”