Chimiothérapie per os et cancer colorectal

Two new drugs of chemotherapy, which are oral 5FU analogues: capecitabine and UFT, have been recently proposed to treat patients with colorectal metastatic. Large phase III trials have shown that a monotherapy with these agents was as effective as a treatment with the American standard of care in this disease: combination of 5FU and folinic acid according to Mayo Clinic schedule. The differences between the oral drugs and standard treatment are clearer in terms of toxicity than in terms of efficacy. There is not yet a direct comparison of the two oral drugs, but the difference between these two agents seems to be clearer in terms of toxicity. The predominant side effect of capecitabine is hand foot syndrome and the predominant side effect of UFT is diarrhea. These new agents will be especially interesting for their used in combination chemotherapy with irinotecan or oxaliplatin or radiochemotherapy. Precise evaluation of the benefit of these agents should be done in large randomized trials but it seems already clear that they will challenge 5FU in the near future.