Capecitabine: Uses And Side Effects

Capecitabine is a chemotherapy drug that is marketed under the brand name Xeloda. This anticancer drug -antineoplastic or cytotoxic- is classified within the therapeutic group of alkylating agents. It is used primarily for the treatment of metastatic breast, colon, or rectal cancer.

Breast and colorectal cancer remain incurable diseases today, although manageable. They have a median survival of 18-24 months and 12-18 months respectively. Treatments seek to improve quality of life and prolong survival.

The introduction of capecitabine represented an advance in the treatment of this type of cancer since:

• It allows a more comfortable chemotherapy treatment because it is administered orally and not intravenously as is done with traditional chemotherapy. This provides greater acceptance and compliance by patients, avoiding complications and associated economic costs.

• It causes a selective activation in the tumor that potentially enables a localized treatment with the consequent improvement of antitumor activity and reduction of systemic toxicity.

In metastatic breast and colorectal cancer, it has been tested as monotherapy or in combination with other chemotherapeutic drugs. Both forms of treatment have been successful both in terms of efficacy and tolerance.

Breast cancer overview

Breast cancer is the most common malignancy and the second leading cause of cancer-related death in women in Western Europe and North America.

Although its incidence is increasing, mortality rates have decreased since 1990. This is probably due to the early diagnosis made by mammographic screening and the increased use of adjuvant intravenous therapy.

Despite these early detection programs, between 5-8% of breast neoplasms are metastatic at diagnosis. Metastatic breast cancer is a disease with highly variable clinical manifestations and which currently constitutes one of the great challenges in research in clinical practice in oncology.

Colorectal Cancer Overview

Colorectal cancer is also a very common neoplasm in developed countries.  It is the third cause of mortality in both sexes. The development of adjuvant chemotherapy, which is the one administered after tumor surgery, led to a slight improvement in patient survival.

However, according to studies,  approximately 30% of diagnosed patients will develop metastatic disease. The liver is the organ most affected by metastases.

How does Capecitabine work in the body?

Capecitabine has a structure that, after administration, allows it to be rapidly absorbed from the intestine. This fact significantly reduces the risk of triggering digestive toxic effects. Capecitabine is transformed in the body into another compound -fluoridine monophosphate- that has cytotoxic activity, that is, it causes cell death.

Once absorbed, capecitabine would act on the most aggressive cancer cells. As a consequence, it would have a greater effect in patients with tumors with a poorer prognosis.

Main Adverse Reactions of Capecitabine

The most common adverse reactions related to capecitabine alone or in combination therapies with other chemotherapy drugs are:

• Gastrointestinal problems : diarrhea, nausea, vomiting, abdominal pain and stomatitis.
• Fatigue
• Hand-foot syndrome or palmoplantar erythrodysesthesia: it is the best known adverse reaction produced by this drug. It causes redness, swelling and pain in the palms of the hands and / or the soles of the feet. Sometimes blisters appear and sometimes it also appears in other areas of the body such as the knees or elbows.

Conclution

The development of capecitabine has led to an advance in the treatment of both metastatic breast and colorectal cancers. It allows an oral administration, which is more comfortable for the patient, and the adverse effects are less serious.

Despite having made huge strides in the treatment of different cancers, possible treatments for these diseases must continue to be vigorously investigated. The global goal is to reduce mortality from them as much as possible.