Capecitabine: preclinical pharmacology studies.

Article Details

Citation

Ishitsuka H

Capecitabine: preclinical pharmacology studies.

Invest New Drugs. 2000 Nov;18(4):343-54.

PubMed ID
11081570 [ View in PubMed
]
Abstract

Capecitabine (N4-pentyloxycarbonyl-5'-deoxy-5-fluorocytidine) is a novel fluoropyrimidine carbamate, which was designed to be sequentially converted to 5-fluorouracil (5-FU) by three enzymes located in the liver and in tumors; the final step is the conversion of 5'-deoxy-5-fluorouridine (5'-DFUR) to 5-FU by thymidine phosphorylase (dThdPase) in tumors. In human cancer xenograft models, capecitabine given orally yielded substantially higher concentrations of 5-FU within tumors than in plasma or normal tissue (muscle). The tumor 5-FU levels were also much higher than those achieved by intravenous administration of 5-FU at equitoxic doses. Capecitabine and its intermediates are not cytotoxic by themselves, but become effective after their conversion to 5-FU. This tumor selective delivery of 5-FU ensured greater efficacy and a more favorable safety profile than with other fluoropyrimidines. In 24 human cancer xenograft models studied, capecitabine was more effective at a wider dose range and had a broader spectrum of antitumor activity than 5-FU, UFT or its intermediate metabolite 5'-DFUR. The susceptibility of the xenografts to capecitabine correlated with tumor dThdPase levels. Moreover, the conversion of 5'-DFUR to 5-FU by dThdPase in tumor was insufficient in a xenograft model refractory to capecitabine. In addition, the efficacy of capecitabine was enhanced by dThdPase up-regulators, such as taxanes and cyclophosphamide. The efficacy of capecitabine may, therefore, be optimized by selecting the most appropriate patient population based on dThdPase status and/or by combining it with dThdPase up-regulators. Capecitabine has additional characteristics not found with 5-FU, such as potent antimetastatic and anticachectic actions in mouse tumor models. With this profile, capecitabine may have substantial potential in cancer treatment.

DrugBank Data that Cites this Article

Drug Enzymes
DrugEnzymeKindOrganismPharmacological ActionActions
CapecitabineCytidine deaminaseProteinHumans
No
Substrate
Details
CapecitabineLiver carboxylesterase 1ProteinHumans
No
Substrate
Details
CapecitabineThymidine phosphorylaseProteinHumans
No
Substrate
Details