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Comparative Study
. 2009 Sep 21;15(35):4415-22.
doi: 10.3748/wjg.15.4415.

Capecitabine treatment patterns in patients with gastroesophageal cancer in the United States

Muhammad Wasif Saif  1 , Nianwen Shi, Susan Zelt
Affiliations
Comparative Study

Capecitabine treatment patterns in patients with gastroesophageal cancer in the United States

Muhammad Wasif Saif et al. World J Gastroenterol. .

Abstract

Aim: To assess the use of capecitabine-based therapy and associated complication rates in patients with gastroesophageal cancer (GEC) in a real-world treatment setting.

Methods: Patients with claims between 2004 and 2005 were identified from the Thomson Reuters MarketScan databases. Capecitabine regimens were compared with 5-fluorouracil (5-FU) and other chemotherapy regimens, and were stratified by treatment setting.

Results: We identified 1013 patients with GEC: approximately half had treatment initiated with a 5-FU regimen, whereas 11% had therapy initiated with a capecitabine regimen. The mean capecitabine dose overall was 2382 +/- 1118 mg/d, and capecitabine was used as monotherapy more often than in combination. Overall, 5-FU regimens were the most common treatment option in neoadjuvant and adjuvant settings, while other non-capecitabine regimens were used more widely in first- and second-line settings. The overall unadjusted complication rate for capecitabine regimens was about half of that seen with 5-FU regimens. In multivariate analyses, capecitabine recipients had a 51% (95% CI: 26%-81%) lower risk of developing any complication than 5-FU recipients did. The risk of developing bone marrow, constitutional, gastrointestinal tract, infectious, or skin complications was lower with capecitabine therapy than with 5-FU.

Conclusion: Capecitabine appeared to have a favorable side effect profile compared with 5-FU, which indicates that it may be a treatment option for GEC.

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Figures

Figure 1
Figure 1
Chemotherapy treatment patterns across all settings in patients with GEC (n = 1013).
Figure 2
Figure 2
Distribution of chemotherapy by treatment setting.
Figure 3
Figure 3
Adjusted complication hazard ratio: 5-FU vs capecitabine regimens. A: 5-FU monotherapy compared with capecitabine monotherapy; B: 5-FU combination compared with capecitabine combination; C: Any 5-FU regimen compared with any capecitabine regimen. Complications were determined per 1000 person-months.
See this image and copyright information in PMC

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