Current status of oral chemotherapy for colorectal cancer

The treatment of advanced colorectal cancer over the past 4 decades has req uired the use of intravenous chemotherapy, most typically fluorouracil (5-F U). The possibility of providing mt alternative to intravenous delivery whi le at the same time improving the quality of life of patients who require f luorouracil for advanced or adjuvant therapy has provided the stimulus for the development of oral fluoropyrimidine drugs. Five oral fluoropyrimidine drugs have recently entered clinical trials in the United States, These inc lude capecitabine (Xeloda), UFT(uracil and tegafur) or UFT/leucovorin (Orze l), eniluracil (ethynyluracil) S-1, and BOF A-2, At least two of these drug s have demonstrated survival equivalent to the standard intravenous fluorou racil and leucovorin regimens used to treat advanced colorectal cancer. Thi s, together,with less severe toxicity and potential increased quality of li fe, should lead to approval of one or more of these oral agents in the near future. Based on both patient and physician acceptance of oral fluoropyrim idines, other oral drugs from classes other than fluoropyrimidines will lik ely be developed in the near future.