open access

Vol 7, No 3 (2011)
Review paper
Published online: 2011-08-23
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Capecitabine in the treatment of advanced gastric cancer

Agnieszka Domurad, Jacek Kryński, Zbigniew I. Nowecki, Lucjan S. Wyrwicz
Onkol. Prak. Klin 2011;7(3):119-126.

open access

Vol 7, No 3 (2011)
REVIEW ARTICLES
Published online: 2011-08-23

Abstract

Treatment of advanced gastric cancer has evolved over the past 20 years and includes adjuvant treatment as well as multidrug chemotherapy. Such treatments are associated with improved median overall survival rates between 3 and 11 months. In clinical practice, and also according to expert opinion, there is still no consensus regarding: the indications for the use of palliative treatment; the composition of chemotherapy; the complexity of chemotherapy programs (double- or triple-drug combinations); and the merits of second line treatments.
Classical programs of palliative chemotherapy of gastric cancer are based on an extended multiday use of 5-fluorouracil (5-FU). In this respect, a significant change was brought about with the use of capecitabine, which is an orally-available prodrug form of fluoropyrimidine. The active metabolites of capecitabine display high anticancer activity.
In Phase III of REAL-2 and ML17032 it was demonstrated that, in combination with platinum derivatives, capecitabine is not less effective than 5-FU in the same regimens when used for patients with advanced gastric cancer. A meta-analysis of these studies showed that the use of capecitabine, in place of 5-FU, significantly extended overall survival. Furthermore, the toxicity profile and time to progression appeared the same when the two drugs were compared.
The paper presents the current state of knowledge relating to the use of capecitabine in the treatment of gastric cancer. To this end, both pre-registration and post-registration clinical studies were identified in the systematic review of the literature.
Onkol. Prak. Klin. 2011; 7, 3: 119–126

Abstract

Treatment of advanced gastric cancer has evolved over the past 20 years and includes adjuvant treatment as well as multidrug chemotherapy. Such treatments are associated with improved median overall survival rates between 3 and 11 months. In clinical practice, and also according to expert opinion, there is still no consensus regarding: the indications for the use of palliative treatment; the composition of chemotherapy; the complexity of chemotherapy programs (double- or triple-drug combinations); and the merits of second line treatments.
Classical programs of palliative chemotherapy of gastric cancer are based on an extended multiday use of 5-fluorouracil (5-FU). In this respect, a significant change was brought about with the use of capecitabine, which is an orally-available prodrug form of fluoropyrimidine. The active metabolites of capecitabine display high anticancer activity.
In Phase III of REAL-2 and ML17032 it was demonstrated that, in combination with platinum derivatives, capecitabine is not less effective than 5-FU in the same regimens when used for patients with advanced gastric cancer. A meta-analysis of these studies showed that the use of capecitabine, in place of 5-FU, significantly extended overall survival. Furthermore, the toxicity profile and time to progression appeared the same when the two drugs were compared.
The paper presents the current state of knowledge relating to the use of capecitabine in the treatment of gastric cancer. To this end, both pre-registration and post-registration clinical studies were identified in the systematic review of the literature.
Onkol. Prak. Klin. 2011; 7, 3: 119–126
Get Citation

Keywords

gastric cancer; chemotherapy; capecitabine

About this article
Title

Capecitabine in the treatment of advanced gastric cancer

Journal

Oncology in Clinical Practice

Issue

Vol 7, No 3 (2011)

Article type

Review paper

Pages

119-126

Published online

2011-08-23

Bibliographic record

Onkol. Prak. Klin 2011;7(3):119-126.

Keywords

gastric cancer
chemotherapy
capecitabine

Authors

Agnieszka Domurad
Jacek Kryński
Zbigniew I. Nowecki
Lucjan S. Wyrwicz

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