Roche's Xeloda effective for stomach cancer

Roche's oral chemotherapy tablet Xeloda (capecitabine) is confirmed as a first-line treatment for advanced stomach cancer, according to a research data published recently in the New England Journal of Medicine.

The publication reinforces the drug's use for this difficult-to-treat disease, enabling clinicians to prescribe Xeloda in combination with platinum-based chemotherapy. Stomach cancer is the fourth most commonly diagnosed cancer and the second leading cause of cancer-related deaths worldwide. Annually, there are an estimated 911,000 deaths worldwide, with nearly 140,000 deaths in Europe alone.

Thanks to this advance, patients with stomach cancer will also benefit from this effective and flexible oral treatment option. This is another example of how the oral chemotherapy pill Xeloda is replacing standard continuous intravenous (i.v.) therapies for patients with gastrointestinal cancers.

"As an oral chemotherapy, capecitabine gives patients a valuable option over the current standard of intravenous treatment," said Professor David Cunningham, Head of the Gastrointestinal and Lymphoma Units of the Royal Marsden NHS Foundation Trust, London. "Capecitabine is at least as effective as intravenous treatment and reduces the time patients need to spend in the hospital allowing patients to lead more routine lives and have more personal time. It may also avoid the need for a central intravenous line with its associated inconvenience and complications".

There is growing consensus that oral therapies should replace i.v. alternatives as long as they can demonstrate at least equivalent efficacy and that tolerability is not compromised. 82 per cent of US oncologists interviewed in a survey stated that their key consideration in selecting an oral chemotherapy agent was efficacy at least equivalent to iv alternatives.

The approval of Xeloda in combination with platinum-based chemotherapy (with or without epirubicin), was based on two trials called ML170325 and REAL-2 6; the latter was published this week in the New England Journal of Medicine. Both these trials showed that patients on the Xeloda-containing arms lived as long overall as those on the 5-FU arms.

Xeloda (capecitabine), known as a 'smart pill' Xeloda is designed to be activated by an enzyme present at higher levels in cancer cells, preserving more normal, healthy cells. This results in favourable tolerability and more convenient treatment, as compared with current standard i.v. chemotherapy. Xeloda is an oral chemotherapy pill that is licensed for advanced gastric cancer, advanced breast cancer and colorectal (bowel) cancer including colorectal cancer that has spread (metastatic), and following potentially curative surgery for colon cancer.The most commonly reported adverse events with Xeloda include diarrhoea, abdominal pain, nausea, stomatitis and hand-foot syndrome (palmar-plantar erythrodysesthaesia).