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| |  Oral Capecitabine Noninferior to Intravenous 5-Fluorouracil in Gastric, Colorectal Cancer: Presented at ASCO-GI By Ed Susman ORLANDO, F la -- January 25, 2010 -- A meta-analysis that includes more than 6,000 gastric or colorectal cancer patients demonstrates that patients assigned to oral capecitabine do as well -- and perhaps better -- than patients who are assigned to receive intravenous 5-fluorouracil. “These findings support the already extensive evidence available from individual clinical trials for the therapeutic equivalence of intravenous 5-fluorouracil and oral capecitabine in colorectal and gastric cancer,” said James Cassidy, MD, University of Glasgow, Glasgow, United Kingdom, on January 24 here at the 2010 Gastrointestinal Cancers Symposium (ASCO-GI). Dr. Cassidy and colleagues pooled results from 6 studies and compared outcomes among 3,074 patients who received 5-fluorouracil-containing therapies with 3,097 patients who received therapies containing capecitabine. In the meta-analysis, about 58% of the patients were men, and the patients’ median age was 60 years. About 99% of the patients in these studies were in Eastern Cooperative Oncology Group performance status 0-1. The overall survival analysis found a 5% reduction in the risk of mortality for patients who were receiving capecitabine (P = .0703). “Capecitabine can be considered a suitable alternative to 5-fluorouracil,” Dr. Cassidy said. The studies included in the meta-analysis compared the 2 drugs in first line treatment of metastatic colorectal cancer, in resected stage III colon cancer, as second-line therapy in metastatic colorectal cancer, and in first-line gastric cancer. Dr. Cassidy said all the analyses were performed on an intent-to-treat basis. The results were also confirmed though a multivariate Cox regression analysis. The most important prognostic factor for overall survival in the meta-analysis was a performance status greater than 0. The median time to events in the patients receiving 5-fluorouracil was 22.5 months compared with 23.1 months for patients receiving capecitabine. The study was funded by F. Hoffmann-La Roche. The 2010 Gastrointestinal Cancers Symposium is sponsored by the American Gastroenterological Association Institute, the American Society of Clinical Oncology, the American Society for Therapeutic Radiation Oncology, and the Society of Surgical Oncology. [Presentation title: Efficacy of Capecitabine vs 5-FU in Colorectal and Gastric Cancer: Meta-Analysis of Survival in 6 Clinical Trials. Abstract 340]
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