Brief Articles
Copyright ©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Sep 21, 2009; 15(35): 4415-4422
Published online Sep 21, 2009. doi: 10.3748/wjg.15.4415
Capecitabine treatment patterns in patients with gastroesophageal cancer in the United States
Muhammad Wasif Saif, Nianwen Shi, Susan Zelt
Muhammad Wasif Saif, Gastrointestinal Cancers Program, Yale Medical Oncology, New Haven, CT 06519, United States
Nianwen Shi, Thomson Reuters, Cambridge, MA 02140, United States
Susan Zelt, Medical Data Management and Analytics, Roche, Nutley, NJ 07110, United States
Author contributions: Saif MW, Shi N, and Zelt S contributed equally to this work, designed the research, performed the research, analyzed the data, and wrote the paper.
Supported by Roche
Correspondence to: Muhammad Wasif Saif, MD, Gastrointestinal Cancers Program, Yale Medical Oncology, 800 Howard Avenue, New Haven, CT 06519, United States. wasif.saif@yale.edu
Telephone: +1-203-737-1569 Fax: +1-203-737-2617
Received: July 27, 2009
Revised: August 21, 2009
Accepted: August 28, 2009
Published online: September 21, 2009
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.

Keywords: Capecitabine; 5-fluorouracil; Hand-foot syndrome; Gastroesophageal cancer