The role of capecitabine in the treatment of colorectal cancer in the elderly

Abstract

To overcome 5-Fluorouracil (5FU) infusion-related problems, oral 5FU precursors and inhibitors of 5FU degradation have been developed. Capecitabine is one of these new oral fluoropyrimidines. Capecitabine treatment of advanced colorectal carcinoma, when compared to 5FU, results in superior response rates (26.6% versus 17.9%, p=0.013), equivalent times to progression and survival, and improved safety, including less stomatitis and myelosuppression. The benefits are principally derived from the avoidance of hospital visits for intravenous drug administration, less expensive drug therapy for the treatment of toxic side-effects, and fewer treatment-related hospitalisations required during the course of therapy for adverse drug reactions. In this review, the use of capecitabine, alone or in association with other drugs, in neoadjuvant, adjuvant and metastatic settings, was analysed in a selected group of elderly patients (> or = 70 years old) affected by colorectal cancer.