Capecitabine

Red

Brand Name(s):Xeloda

Indication: Cancer – breast (Advanced or metastatic) Colorectal (metastatic)
Gastric cancer (Advanced) in combination with a platinum-based regimen

Rationale:1,2,8

Considered:Jul-07

Review Date:Jul-23

Comments:
Jan 2020 – https://www.nice.org.uk/guidance/ng151

MHRA Drug Safety Update
Severe skin reaction associated with Xeloda, http://www.mhra.gov.uk/Safetyinformation/DrugSafetyUpdate/CON364168
January 2014
…………………………
For patients with advanced breast cancer who are not suitable for anthracyclines (because they are contraindicated or because of prior anthracycline treatment either in the adjuvant or metastatic setting), systemic chemotherapy should be offered in the following sequence:
* first line: single-agent docetaxel
* second line: single-agent vinorelbine or capecitabine
* third line: single-agent capecitabine or vinorelbine (whichever was not used as second-line treatment)…………………………https://www.ema.europa.eu/en/news/meeting-highlights-pharmacovigilance-risk-assessment-committee-prac-9-12-march-2020. Patients receiving iv or intraarterial fluorouracil, or capecitabine or tegafur (both prodrugs of FU), should be tested for lack of dihydropyrimidine dehydrogenase (DPD) before starting treatment. Lack of DPD may lead to fluorouracil toxicity eg neutropenia, neurotoxicity.