Intravenous bolus fluorouracil plus leucovorin is the standard adjuvant treatment for colon cancer.
The oral fluoropyrimidine capecitabine is an established alternative to bolus fluorouracil plus leucovorin as first-line treatment for metastatic colorectal cancer.
Dr Chris Twelves and colleagues evaluated capecitabine in the adjuvant setting.
|Capecitabine improves relapse-free survival and is associated with fewer adverse events|
|New England Journal of Medicine|
The researchers randomly assigned a total of 1987 patients with resected stage III colon cancer.
The team randomized 1004 patients to receive either oral capecitabine and 983 received bolus fluorouracil plus leucovorin over a period of 24 weeks.
The primary efficacy end point was at least equivalence in disease-free survival.
The researchers considered the incidence of grade 3 or 4 toxic effects due to fluoropyrimidines as the primary safety end point.
The team found that disease-free survival in the capecitabine group was at least equivalent to that in the fluorouracil-plus-leucovorin group.
The researchers noted that capecitabine improved relapse-free survival and was associated with fewer adverse events than fluorouracil plus leucovorin.
Dr Twelves' team concludes, “Oral capecitabine is an effective alternative to intravenous fluorouracil plus leucovorin in the adjuvant treatment of colon cancer.”