Are you a Health Professional? Jump over to the doctors only platform. Click Here

Hot from ESMO – Tablet Chemotherapy – Better for everyone?

Print Friendly, PDF & Email

Continuing on our reports from ESMO, the first day of the conference featured some outstanding presentations in which one of the main focuses was in maintaining the efficiency of treatment while improving quality of life for people taking treatment. Yesterday, we focused on new treatments for relapsed lymphomas which showed good tolerability of treatment with minimal toxicity. Today, we look at a different route administration.

Nine out of ten patients prefer oral chemotherapy to intravenous chemotherapy, in a study by Liu presented in the journal of clinical oncology in 1997. This was qualified by saying that this was true as longer as the effectiveness of the chemotherapy was not sacrifice.

A study which conferred patients receiving chemotherapy at home versus chemotherapy in hospital showed that patients receiving chemotherapy at home had much better quality of life. This is one of the reasons why there has been a shift towards chemotherapy treatments which minimise in hospital time.

So what is happening from an Australian perspective?

Well, there are a number of exciting developments in recent times which is seeing an increasing number of tablet type chemotherapy is emerging.
Capecitabine (Xeloda) is a tablet version of 5-FU which has been an effective part of many different chemotherapy regimens for many years. It is used routinely to treat bowel cancer (rectum, colon, caecum), oesophageal cancer, stomach cancer, pancreatic cancer, head and neck cancer and a variety of others. Fludarabine has been used as an injection to treat a variety of leukaemias but this year has seen the production of an oral form of this treatment. This promises to improve the quality of life of patients undergoing leukaemia treatment. Tablet chemotherapy is also used to treat brain tumours, some lymphomas and myeloma.

Standard 5-FU is given by injection either by continuous infusion or daily injections, usually for five days at a time. Its effects are enhanced by the administration of folinic acid. It has been the gold standard of treatment for colon cancer for many years. Is this about to change?

Evidence presented at the conference yesterday looked at existing data regarding the tablet version of this drug, capecitabine. In one comparative trial, the response rate to capecitabine was higher then the current gold standard, 5-FU. Survival was equivalent. The intravenous treatment had more toxicity generally, especially in producing alopecia (baldness). The tablet version did however cause more problems of sore hands and feet.

There is thus an emerging case for a shift away from intravenous 5FU to the oral version for first line treatment.

Other information from this conference will look at combining this treatment with some of the other newer treatment agents for bowel cancer, pancreatic cancer, breast cancer and others.

For further information see the Capecitabine section, located in the pharmacy of the virtual cancer centre.

Print Friendly, PDF & Email


Posted On: 19 October, 2002
Modified On: 3 December, 2013


Created by: myVMC