Cancer Treatment Today

cCapecitabine (Xeloda®; Hoffmann-La Roche Inc., Nutley, NJ) is an orally administered fluoropyrimidine carbamate used to treat breast and colorectal cancer. Readily absorbed by the gastrointestinal tract, capecitabine is metabolized by the enzyme carboxylesterase in the liver, where it is converted to 5′ deoxy-5-fluorocytidine (5′ DFCR), which is then converted by the enzyme cytidine deaminase to 5′ deoxy-5-fluorouridine (5′ DFUR). As a result, orally administered capecitabine enables physicians treating breast cancer to mimic the effect of continuous infusion 5-FU but in a convenient outpatient setting without the complications and costs associated with infusion pumps and parenteral therapies. Capecitabine was approved in 1998 by the U.S. Food and Drug Administration as a single agent for patients with metastatic breast cancer that is resistant to both paclitaxel and anthracyclines, and for those with breast cancer resistant to paclitaxel and for whom further anthracycline therapy is contraindicated. Capecitabine is also approved for combination therapy with docetaxel for the treatment of patients with metastatic breast cancer in whom prior anthracycline-based therapy has failed.

There is phase II data on combining capecitabine with gemcitabine. I was able to find three sudies that claim effectiveness for this combination.

Lambea J, Isla D, Saenz-Cusi A, Escudero P, Tres A. et al, Gemcitabine/capecitabine in patients with metastatic breast cancer pretreated with anthracyclines and taxanes. Clin Breast Cancer. 2005 Jun;6(2):158-62. Andres R, Mayordomo J, Isla D et al. Capecitabine plus gemcitabine is an active combination for patients with metastatic breast cancer refractory to anthracyclines and taxanes. Proc Am Soc Clin Oncol 2003;22:89. Manga G, Lopez-Criado P, Mendez M et al. Gemcitabine (G) plus capecitabine (C) in previously treated metastatic breast cancer (MBC) patients: results from a phase II GOTI trial. Proc Am Soc Clin Oncol 2003;22:66.