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Are Capecitabine and 5FU Equivalent When Combined with Radiotherapy?

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Multidisciplinary Management of Rectal Cancer

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Abstract

For more than four decades, the treatment of colorectal cancer (CRC) consisted almost exclusively of the fluoropyrimidine 5-fluorouracil (5FU) (eventually modulated by folinic acid or levamisole). Administration of 5FU is confined to either implanted venous access ports or inpatient treatment. Thus, the development of capecitabine, an oral fluoropyrimidine carbamate working as 5FU prodrug, relevantly facilitated treatment for CRC patients. Capecitabine (Xeloda®) was initially licensed for the treatment of metastatic colorectal cancer mainly based on two large multicenter studies, both comparing the oral drug with a common 5FU/leucovorin combination (Mayo regimen) [6, 15]. Further trials showed the similar efficacy of capecitabine in the adjuvant setting and in combination regimen (particular with oxaliplatin) [2, 13].

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References

  1. Allegra CJ, Yothers G, O’Connell MJ, Beart RW, Wozniak TF, Pitot HC, Shields AF, Landry JC, Ryan DP, Arora A, Evans LS, Bahary N, Soori G, Eakle JF, Robertson JM, Moore DF Jr, Mullane MR, Marchello BT, Ward PJ, Sharif S, Roh MS, Wolmark N (2015) Neoadjuvant 5-FU or capecitabine plus radiation with or without oxaliplatin in rectal cancer patients: a phase III randomized clinical trial. J Natl Cancer Inst 107(11):pii: djv248

    Article  Google Scholar 

  2. Arkenau HT, Arnold D, Cassidy J, Diaz-Rubio E, Douillard JY, Hochster H, Martoni A, Grothey A, Hinke A, Schmiegel W, Schmoll HJ, Porschen R (2008) Efficacy of oxaliplatin plus capecitabine or infusional fluorouracil/leucovorin in patients with metastatic colorectal cancer: a pooled analysis of randomized trials. J Clin Oncol 26(36):5910–5917

    Article  CAS  PubMed  Google Scholar 

  3. Crane CH, Eng C, Feig BW, Das P, Skibber JM, Chang GJ, Wolff RA, Krishnan S, Hamilton S, Janjan NA, Maru DM, Ellis LM, Rodriguez-Bigas MA (2010) Phase II trial of neoadjuvant bevacizumab, capecitabine, and radiotherapy for locally advanced rectal cancer. Int J Radiat Oncol Biol Phys 76(3):824–830

    Article  CAS  PubMed  Google Scholar 

  4. Dunst J, Reese T, Sutter T, Zuhlke H, Hinke A, Kolling-Schlebusch K, Frings S (2002) Phase I trial evaluating the concurrent combination of radiotherapy and capecitabine in rectal cancer. J Clin Oncol 20(19):3983–3991

    Article  CAS  PubMed  Google Scholar 

  5. Gerard JP, Azria D, Gourgou-Bourgade S, Martel-Lafay I, Hennequin C, Etienne PL, Vendrely V, Francois E, de La Roche G, Bouche O, Mirabel X, Denis B, Mineur L, Berdah JF, Mahe MA, Becouarn Y, Dupuis O, Lledo G, Seitz JF, Bedenne L, Juzyna B, Conroy T (2012) Clinical outcome of the ACCORD 12/0405 PRODIGE 2 randomized trial in rectal cancer. J Clin Oncol 30(36):4558–4565

    Article  CAS  PubMed  Google Scholar 

  6. Hoff PM, Ansari R, Batist G, Cox J, Kocha W, Kuperminc M, Maroun J, Walde D, Weaver C, Harrison E, Burger HU, Osterwalder B, Wong AO, Wong R (2001) Comparison of oral capecitabine versus intravenous fluorouracil plus leucovorin as first-line treatment in 605 patients with metastatic colorectal cancer: results of a randomized phase III study. J Clin Oncol 19(8):2282–2292

    Article  CAS  PubMed  Google Scholar 

  7. Hofheinz RD, Wenz F, Post S, Matzdorff A, Laechelt S, Hartmann JT, Muller L, Link H, Moehler M, Kettner E, Fritz E, Hieber U, Lindemann HW, Grunewald M, Kremers S, Constantin C, Hipp M, Hartung G, Gencer D, Kienle P, Burkholder I, Hochhaus A (2012) Chemoradiotherapy with capecitabine versus fluorouracil for locally advanced rectal cancer: a randomised, multicentre, non-inferiority, phase 3 trial. Lancet Oncol 13(6):579–588

    Article  CAS  PubMed  Google Scholar 

  8. Kim JC, Kim TW, Kim JH, Yu CS, Kim HC, Chang HM, Ryu MH, Park JH, Ahn SD, Lee SW, Shin SS, Kim JS, Choi EK (2005) Preoperative concurrent radiotherapy with capecitabine before total mesorectal excision in locally advanced rectal cancer. Int J Radiat Oncol Biol Phys 63(2):346–353

    Article  CAS  PubMed  Google Scholar 

  9. O’Connell MJ, Colangelo LH, Beart RW, Petrelli NJ, Allegra CJ, Sharif S, Pitot HC, Shields AF, Landry JC, Ryan DP, Parda DS, Mohiuddin M, Arora A, Evans LS, Bahary N, Soori GS, Eakle J, Robertson JM, Moore DF Jr, Mullane MR, Marchello BT, Ward PJ, Wozniak TF, Roh MS, Yothers G, Wolmark N (2014) Capecitabine and oxaliplatin in the preoperative multimodality treatment of rectal cancer: surgical end points from national surgical adjuvant breast and bowel project trial R-04. J Clin Oncol 32(18):1927–1934

    Article  PubMed  PubMed Central  Google Scholar 

  10. Sawada N, Ishikawa T, Sekiguchi F, Tanaka Y, Ishitsuka H (1999) X-ray irradiation induces thymidine phosphorylase and enhances the efficacy of capecitabine (Xeloda) in human cancer xenografts. Clin Cancer Res 5(10):2948–2953

    CAS  PubMed  Google Scholar 

  11. Schilsky RL (2000) Pharmacology and clinical status of capecitabine. Oncology (Williston Park) 14(9):1297–1306. discussion 1309-1211

    CAS  Google Scholar 

  12. Schmoll HJ, Haustermans K, Price T (2014) Preoperative chemoradiotherapy and postoperative chemotherapy with capecitabine and oxaliplatin versus capecitabine alone in locally advanced rectal cancer: disease-free survival results at interim analysis. J Clin Oncol 32(5s):abstr. 3501

    Google Scholar 

  13. Schmoll HJ, Twelves C, Sun W, O’Connell MJ, Cartwright T, McKenna E, Saif M, Lee S, Yothers G, Haller D (2014) Effect of adjuvant capecitabine or fluorouracil, with or without oxaliplatin, on survival outcomes in stage III colon cancer and the effect of oxaliplatin on post-relapse survival: a pooled analysis of individual patient data from four randomised controlled trials. Lancet Oncol 15(13):1481–1492

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Schuller J, Cassidy J, Dumont E, Roos B, Durston S, Banken L, Utoh M, Mori K, Weidekamm E, Reigner B (2000) Preferential activation of capecitabine in tumor following oral administration to colorectal cancer patients. Cancer Chemother Pharmacol 45(4):291–297

    Article  CAS  PubMed  Google Scholar 

  15. Van Cutsem E, Twelves C, Cassidy J, Allman D, Bajetta E, Boyer M, Bugat R, Findlay M, Frings S, Jahn M, McKendrick J, Osterwalder B, Perez-Manga G, Rosso R, Rougier P, Schmiegel WH, Seitz JF, Thompson P, Vieitez JM, Weitzel C, Harper P, Xeloda G, Colorectal Cancer Study (2001) Oral capecitabine compared with intravenous fluorouracil plus leucovorin in patients with metastatic colorectal cancer: results of a large phase III study. J Clin Oncol 19(21):4097–4106

    Article  CAS  PubMed  Google Scholar 

  16. Wadlow RC, Ryan DP (2010) The role of targeted agents in preoperative chemoradiation for rectal cancer. Cancer 116(15):3537–3548

    Article  CAS  PubMed  Google Scholar 

  17. Willett CG, Duda DG, di Tomaso E, Boucher Y, Ancukiewicz M, Sahani DV, Lahdenranta J, Chung DC, Fischman AJ, Lauwers GY, Shellito P, Czito BG, Wong TZ, Paulson E, Poleski M, Vujaskovic Z, Bentley R, Chen HX, Clark JW, Jain RK (2009) Efficacy, safety, and biomarkers of neoadjuvant bevacizumab, radiation therapy, and fluorouracil in rectal cancer: a multidisciplinary phase II study. J Clin Oncol 27(18):3020–3026

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. Department of Oncology, Haematology, Stem Cell Transplantation with the section Pneumology, Hubertus Wald Tumor Centre University Cancer Centre Hamburg, University Medical Centre Hamburg-Eppendorf, Hamburg, 20246, Germany

    Alexander Stein

  2. Department for Oncology-Haematology, Martin Luther University Halle–Wittenberg, Halle, 06120, Germany

    Hans-Joachim Schmoll

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  1. Alexander Stein
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  2. Hans-Joachim Schmoll
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Correspondence to Hans-Joachim Schmoll .

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Editors and Affiliations

  1. Dept. of Radiation Oncology, Università Cattolica S Cuore, Rome, Italy

    Vincenzo Valentini

  2. Head, Div. Clinical Oncology Research, University Clinic Halle (Saale), Martin-Luther-University Halle-Wittenberg, Halle, Sachsen-Anhalt, Germany

    Hans-Joachim Schmoll

  3. Department of Surgery, Leiden Univ Med Ctr, Leiden, The Netherlands

    Cornelis J. H. van de Velde

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Stein, A., Schmoll, HJ. (2018). Are Capecitabine and 5FU Equivalent When Combined with Radiotherapy?. In: Valentini, V., Schmoll, HJ., van de Velde, C. (eds) Multidisciplinary Management of Rectal Cancer. Springer, Cham. https://doi.org/10.1007/978-3-319-43217-5_34

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  • DOI: https://doi.org/10.1007/978-3-319-43217-5_34

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-43215-1

  • Online ISBN: 978-3-319-43217-5

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