Capecitabine in carcinoma of the pancreas

Abstract

Capecitabine is an oral prodrug of 5-fluorouracil, which is converted to 5-fluorouracil by three sequential enzymatic reactions. The final requisite enzyme, thymidine phosphorylase, is present at consistently higher levels in tumours compared with normal tissues, thereby suggesting that 5-fluorouracil that is delivered in this way may benefit from an element of tumour targeting and thus enhanced selectivity and better tolerability. Capecitabine has been shown to have single-agent activity in advanced carcinoma of the pancreas and to improve response rates and survival when administered in combination with gemcitabine compared with gemcitabine alone. This paper reviews the pharmacology and clinical data that are relevant to the use of capecitabine in pancreatic cancer.

Keywords::

• 5-fluorouracil
• adjuvant
• advanced cancer
• capecitabine
• chemotherapy
• gemcitabine
• pancreas
• pancreatic

Acknowledgements

The authors wish to thank Cancer Research UK for past and ongoing support for the ESPAC adjuvant and the GemCap advanced pancreatic cancer trials.

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