Published online May 28, 2014. doi: 10.3748/wjg.v20.i20.6092
Revised: February 1, 2014
Accepted: March 19, 2014
Published online: May 28, 2014
Fluoropyrimidines play a central role in the first-line treatment of metastatic colorectal cancer. Our aim was to review whether capecitabine was a safer, non-inferior, economically superior and more convenient alternative to 5-fluorouracil. Capecitabine has previously been compared to 5-fluorouracil-either as a monotherapy or in combination with oxaliplatin, irinotecan, or biological drugs-and has been found to have comparable efficacy and safety profiles. Furthermore, pharmacoeconomic data and patients’ preferences for oral chemotherapy further favor capecitabine. Therefore, capecitabine appears to be an effective and safe alternative to fluorouracil in the first-line treatment of metastatic colorectal cancer.
Core tip: Although there is still controversy about whether capecitabine-based regimes can replace 5-fluorouracil (5-FU) in clinical practice in the treatment of first-line metastatic colon cancer, we have reviewed most of different randomized studies and meta-analyses, and we can conclude that capecitabine appear to be an effective, safe, convenient, and economically viable alternative to 5-FU.