Efficacia e tollerabilità della capecitabina, da sola ed in associazione, nel trattamento dei pazienti con tumore del colon: Revisione delle evidenze cliniche

Capecitabine, a pro-drug of 5-fluorouracil (5FU) that can be assumed orally, has shown an efficacy, in terms of progression-free and overall survival, at least equivalent to standard leucovorin (LV)-modulated 5FU regimens in metastatic colorectal cancer patients. Moreover, capecitabine has shown a better tolerability profile, producing significantly lower occurrence of severe stomatitis than 5FU/LV, rendering this drug particularly attractive for treating elderly patients. In addition, capecitabine can be easily combined with other active drugs as irinotecan or oxaliplatin. Indeed, the combination of capecitabine plus oxaliplatin (XELOX regimen) now represents a new standard of care for the metastatic disease, and is also under evaluation in the adjuvant setting. The combination of new biologic therapies such as bevacizumab to the XELOX regimen was shown to further prolong the time to progression of metastatic patients, and might reduce the risk of recurrence for resected colon cancer patients with poor risk factors.