Capecitabine (Xeloda) is an oral fluoropyrimidine which is produced as a pro-drug of fluorouracil, and shows improv.d tolerability and intratumor drug concentrations following its tumor-specif ic conv.rsion to the a...
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Capecitabine (Xeloda) is an oral fluoropyrimidine which is produced as a pro-drug of fluorouracil, and shows improv.d tolerability and intratumor drug concentrations following its tumor-specif ic conv.rsion to the activ. drug. We hav. searched the Pubmed and Cochrane databases from 1980 to 2009 with the purpose of rev.ewing all av.ilable information on Capecitabine, focusing on its clinical effectiv.ness against colorectal cancer. Special attention has been paid to trials that compared Capecitabine with standard folinic acid (leucov.rin, Lv.-modulated intrav.nous 5-fluorouracil (5-FU) bolus regimens in patients with metastatic colorectal cancer. Moreov.r the efficacy of Capecitabine on metastatic colorectal cancer, either alone or in v.rious combinations with other activ. drugs such as Irinotecan and Oxaliplatin was also assessed. Finally, neoadjuv.nt therapy con- sisting of Capecitabine plus radiation therapy, for locally adv.nced rectal cancer was analysed. This combination of chemotherapy and radiotherapy has a special role in tumor down staging and in sphincter preserv.tion for lower rectal tumors. Comparativ. trials hav. shown that Capecitabine is at least equiv.lent to the standard Lv.5-FU combination in relation to progression-free and ov.rall surv.v.l whilst showing a better tolerability prof ile with a much lower incidence of stomatitis. It is now known that Capecitabine can be combined with other activ. drugs such as Irinotecan and Oxaliplatin. The combination of Oxaliplatin with Capecitabine represents a new standard of care for metastatic colorectal cancer. Combinating the Capecitabine-Oxaliplatin regimen with promising new biological drugs such as Bev.cizumab seems to giv. a realistic prospect of further improv.ment in time to progression of metastatic disease. Moreov.r, preoperativ. chemo-radiation using oral capecitabine is better tolerated than bolus 5-FU and is more effectiv. in the promotion of both down-staging and sphincter preserv.tion in patie
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