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

World J Gastroenterol. 2009 Sep 21;15(35):4415-22. doi: 10.3748/wjg.15.4415.

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.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Antimetabolites, Antineoplastic / therapeutic use*
  • Capecitabine
  • Deoxycytidine / analogs & derivatives*
  • Deoxycytidine / therapeutic use
  • Esophageal Neoplasms / drug therapy*
  • Female
  • Fluorouracil / analogs & derivatives*
  • Fluorouracil / therapeutic use*
  • Humans
  • Insurance, Health, Reimbursement / statistics & numerical data
  • Male
  • Middle Aged
  • Retrospective Studies
  • Stomach Neoplasms / drug therapy*
  • Treatment Outcome
  • United States

Substances

  • Antimetabolites, Antineoplastic
  • Deoxycytidine
  • Capecitabine
  • Fluorouracil