AIM: Capecitabine is an oral fluoropyrimidine that can effectively replace infusional 5-fluorouracil (5-FU) for treatment of colorectal, gastric and breast cancer. This study aims to analyze the incidence and the relative risk of grade 3 and 4 diarrhoea in patients treated with capecitabine or 5-FU in randomized clinical trials (RCTs).METHODS: MEDLINE and Cochrane Library were reviewed for RCTs that compared capecitabine with 5-FU for treatment of solid malignancies. The incidence and relative risk (RR) of grade 3/4 diarrhoea were estimated for each arm in the overall population and in colorectal cancer (CRC) patients.RESULTS: Twenty-three studies and 15 761 patients were included. Among these 8303 and 7458 patients received capecitabine or 5-FU based therapies, respectively. In the overall populations severe diarrhoea was reported in 16.6% (95% CI 15.8, 17.4) and in 12.7% (95% CI 11.9, 13.4) of patients treated with capecitabine or 5-FU-based therapies, respectively. The RR was 1.39 (95% CI 1.14, 1.69, P = 0.0010). In 14 899 CRC patients, the incidence of severe diarrhoea was 17.0% (95% CI 16.2, 17.9) and 12.9% (95% CI 12.1, 13.7), respectively, with a RR of 1.46 (95% CI 1.18, 1.81, P < 0.0001). In CRC patients treated with combined chemotherapy, the RR was 1.40 (95% CI 1.07, 1.82; P = 0.01) for patients receiving oxaliplatin and 2.35 (95% CI 1.76, 3.13; P < 0.0001) for patients receiving irinotecan.CONCLUSIONS: Treatment with capecitabine is characterized by an increased risk of severe diarrhoea, mainly in patients affected by CRC and treated with polichemotherapy. Combination treatment with irinotecan doubles the risk over 5-FU.
Incidence and relative risk of grade 3 and 4 diarrhoea in patients treated with capecitabine or 5-fluorouracil : a meta-analysis of published trials / R. Iacovelli, F. Pietrantonio, A. Palazzo, C. Maggi, F. Ricchini, F. De Braud, M. Di Bartolomeo. - In: BRITISH JOURNAL OF CLINICAL PHARMACOLOGY. - ISSN 0306-5251. - 78:6(2014), pp. 1228-1237.
|Titolo:||Incidence and relative risk of grade 3 and 4 diarrhoea in patients treated with capecitabine or 5-fluorouracil : a meta-analysis of published trials|
PIETRANTONIO, FILIPPO (Secondo)
DE BRAUD, FILIPPO GUGLIELMO MARIA (Penultimo)
|Parole Chiave:||5-fluorouracil; Breast cancer; Capecitabine; Colorectal cancer; Diarrhoea; Gastric cancer; Antimetabolites, Antineoplastic; Capecitabine; Deoxycytidine; Diarrhea; Fluorouracil; Humans; Incidence; Randomized Controlled Trials as Topic; Risk; Pharmacology (medical); Pharmacology|
|Settore Scientifico Disciplinare:||Settore MED/06 - Oncologia Medica|
|Data di pubblicazione:||2014|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1111/bcp.12449|
|Appare nelle tipologie:||01 - Articolo su periodico|
File in questo prodotto:
|Iacovelli_et_al-2014-British_Journal_of_Clinical_Pharmacology.pdf||Publisher's version/PDF||Administrator Richiedi una copia|