Efficacy of capecitabine versus 5-fluorouracil in colorectal and gastric cancers: a meta-analysis of individual data from 6171 patients.

Abstract

BACKGROUND:

To compare the effects of oral capecitabine-containing chemotherapy regimens with i.v. 5-fluorouracil (5-FU)-containing chemotherapy regimens on overall survival in patients with gastrointestinal cancers.

METHODS:

A meta-analysis, based on individual patient data from six randomised non-inferiority trials, was carried out at the request of regulatory authorities to compare the effects of single-agent capecitabine or capecitabine-containing chemotherapy versus matched 5-FU-based regimens in terms of overall survival in patients with stage III colon, metastatic colorectal or advanced gastric cancer.

RESULTS:

Data from a total of 6171 patients with stage III colon cancer (n = 1987), metastatic colorectal cancer (n = 3868) or advanced gastric cancer (n = 316) were included. A total of 3097 patients were treated with capecitabine-containing chemotherapy and 3074 patients with 5-FU-containing chemotherapy. The unadjusted hazard ratio for overall survival for capecitabine-containing chemotherapy versus 5-FU-containing chemotherapy was 0.94 (95% confidence interval 0.89-1.00; P = 0.0489).

CONCLUSIONS:

Oral capecitabine is at least equivalent to i.v. 5-FU in terms of overall survival in patients with gastrointestinal cancers. Capecitabine and 5-FU can be used interchangeably in these patient populations.

• Authors: J Cassidy, L Saltz, C Twelves, E Van Cutsem, P Hoff, Y Kang, J P Saini, F Gilberg, D Cunningham
• Journal: Annals of oncology : official journal of the European Society for Medical Oncology (Ann Oncol) Vol. 22 Issue 12 Pg. 2604-2609 (Dec 2011) ISSN: 1569-8041 [Electronic] England
• PMID: 21415237 (Publication Type: Comparative Study, Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't)

Chemical References

• Antineoplastic Agents
• Deoxycytidine
• Capecitabine
• Fluorouracil

Topics

• Antineoplastic Agents (therapeutic use)
• Capecitabine
• Colorectal Neoplasms (drug therapy, mortality)
• Deoxycytidine (analogs & derivatives, therapeutic use)
• Female
• Fluorouracil (analogs & derivatives, therapeutic use)
• Humans
• Kaplan-Meier Estimate
• Male
• Multivariate Analysis
• Randomized Controlled Trials as Topic
• Stomach Neoplasms (drug therapy, mortality)
• Treatment Outcome