Oral Anticancer Drug Provides New Promise for Advanced Breast Cancer Patients

MIAMISBURG, Ohio - An overview of the development and clinical experience of capecitabine-an orally administered anticancer drug that mimics another drug (5-fluorouracil; 5-FU) requiring infusion into the vein-is featured in the recent issue of The Oncologist (Vol. 6, No. 1, 2001)-the bimonthly international peer-reviewed journal for physicians devoted to cancer patient care.

"The Role of Capecitabine, an Oral, Enzymatically Activated Fluoropyrimidine, in the Treatment of Metastatic Breast Cancer," is an original paper by Dr. Joanne L. Blum, of U.S. Oncology, Dallas, Texas, that looks at the viability of capecitabine (Xeloda®; Hoffmann-La Roche, Inc.) as a treatment option for breast cancer patients.

According to Dr. Blum, a breast cancer expert, there are about 175,000 new cases of breast cancer diagnosed each year in the United States. Of those patients treated with the intent to cure, approximately half will develop metastatic breast cancer, with a medial survival time of 18-30 months following diagnosis of the metastatic disease.

Many metastatic breast cancer patients who had been previously treated (with anthracycline and taxane) become drug resistant to these chemotherapeutic agents. In two large, multi-center, phase II studies with more than 230 patients, capecitabine showed a response rate of 20 percent to 25 percent in patients who had failed treatment with these other drugs. Dr. Blum says that additional on-going clinical trials should help further define the drug's role alone and in combination with other agents.

As an oral agent, capecitabine is more convenient for patients, nurses, and physicians, and permits more home-based therapy, notes Dr. Blum. Capecitabine mimics 5-FU, which must be delivered through infusion. However, capecitabine has another advantage-it is activated by an enzyme that is more active in tumors than normal tissue, meaning it can generate more of the cancer-killing 5-FU directly into the tumor, reducing certain side effects such as hair loss and bone-marrow suppression.

Other articles in the current issue deal with the development and use of irinotecan for colorectal and other cancers; radiofrequency ablation for liver cancer; interferon in oncology practice; "Medical Mistakes: a Workshop on Personal Perspective" from Mass General's Schwartz Center Rounds; the molecular perspective of targeted toxins; an introduction to the human genome; and FDA drug approval summaries.

The Oncologist is a medical journal devoted to practitioners entrusted with cancer patient care. More than 21,000 physicians around the world read it. Its online edition (www.TheOncologist.com) is read by more than 50,000 each month.