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