卡培他滨:回顾其药理学和治疗效果在晚期乳腺癌的管理。

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瓦格斯塔夫AJ, Ibbotson T,果阿KL

卡培他滨:回顾其药理学和治疗效果在晚期乳腺癌的管理。

药。2003;63 (2):217 - 36。

PubMed ID

12515569 (在PubMed

]

文摘

卡培他滨是一种口服药物前体的氟尿嘧啶在美国和欧洲,结合多烯紫杉醇,转移性乳腺癌患者治疗失败的蒽环霉素治疗,和作为单药治疗转移性乳腺癌耐紫杉醇和蒽环霉素治疗失败(美国)或密集化疗(欧洲)。卡培他滨也被批准用于转移性结直肠癌。卡培他滨是新陈代谢优先激活肿瘤部位,并显示与其他细胞毒性抗肿瘤药活动,协同代理包括环磷酰胺或多烯紫杉醇在动物模型。口服后生物利用度接近100%。预防晚期乳腺癌患者,卡培他滨单药治疗一样有效,同时结合其他代理。与卡培他滨联合治疗1250毫克/米(2)连续两周每天两次每三周循环+静脉多西他赛75毫克/ m(2)每个周期的第一天是优于静脉和多西他赛单药治疗100毫克/米(2)每个周期的第一天。卡培他滨+多烯紫杉醇明显病情恶化甚至死亡的风险降低了35% (p = 0.0001)和23% (p < 0.05),分别和生存中值显著升高(p < 0.05)和客观反应率(p < 0.01)。功效也被证明与卡培他滨单药治疗和联合治疗在以前未经治疗的病人在初步试验。最常见的不良反应发生在接受卡培他滨单药治疗的病人包括淋巴细胞减少、贫血、腹泻、手脚综合症、恶心、疲劳、hyperbilirubinaemia、皮炎和呕吐发生率(> 25%)。虽然胃肠道事件和手脚综合症发生更多的比与紫杉醇或卡培他滨方案环磷酰胺、甲氨蝶呤和氟尿嘧啶(CMF)、粒细胞减少性发热、关节痛、发热、肌痛与紫杉醇更常见,并且恶心、口炎、脱发和衰弱和CMF更为常见。 The incidence of adverse effects and hospitalisation was similar in patients receiving capecitabine plus docetaxel and those receiving docetaxel monotherapy. In conclusion, capecitabine, an oral prodrug of fluorouracil which is activated preferentially at the tumour site, is an effective and convenient addition to the intravenous polychemotherapeutic treatment of advanced breast cancer in pretreated patients, and also has potential as a component of first-line combination regimens. Combined capecitabine plus docetaxel therapy resulted in similar rates of treatment-related adverse effects and hospitalisation to those seen with docetaxel monotherapy. Capecitabine is also effective as monotherapy in pretreated patients and phase II data for capecitabine as first-line monotherapy are also promising. While gastrointestinal effects and hand-and-foot syndrome occur often with capecitabine, the tolerability profile was comparatively favourable for other adverse effects (notably, neutropenia and alopecia).

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药物

卡培他滨