5‑Fluorouracil and capecitabine therapies for the treatment of colorectal cancer (Review)

  • Authors:
    • Shiekhah M. Alzahrani
    • Huda A. Al Doghaither
    • Ayat B. Al‑Ghafari
    • Peter N. Pushparaj
  • View Affiliations

  • Published online on: August 7, 2023     https://doi.org/10.3892/or.2023.8612
  • Article Number: 175
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Abstract

Although 5‑fluorouracil (5‑FU)‑based chemotherapy is the major treatment for colorectal cancer, it has disadvantages such as systemic toxicity, lack of effectiveness and selectivity, and development of resistance. Capecitabine, a prodrug form of 5‑FU, was designed to overcome these drawbacks, to fulfill the need for more convenient therapy, and to improve safety, tolerability and intratumor drug concentration levels through a tumor‑specific conversion to the active 5‑FU drug. The purpose of the present review is to provide a comprehensive comparison between 5‑FU therapy and capecitabine. In the current review, anticancer drug classification was discussed and the development of capecitabine from the original fluorinated analogue (5‑FU) to overcome its drawbacks was explained. Specifically, 5‑FU is compared with capecitabine therapy regarding various properties, including drug metabolism, cellular mechanism, effect on the apoptosis pathway and cell cycle phases, safety and tolerability. Moreover, three metabolizing enzymes required for the activation of capecitabine to 5‑FU were discussed. Capecitabine, as monotherapy or in combination with other chemotherapies, exhibited improved drug efficacy and survival. However, the changes that mediate the chemoresistance of capecitabine treatment were classified as intracellular, extracellular or cell surface factors, or cell‑phenotype state. Future studies should examine the efficacy of capecitabine combined with novel and safe drugs other than chemotherapeutic agents that play a role in the inhibition of tumor initiation, progression and metastasis.
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October-2023
Volume 50 Issue 4

Print ISSN: 1021-335X
Online ISSN:1791-2431

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Spandidos Publications style
Alzahrani SM, Al Doghaither HA, Al‑Ghafari AB and Pushparaj PN: 5‑Fluorouracil and capecitabine therapies for the treatment of colorectal cancer (Review). Oncol Rep 50: 175, 2023.
APA
Alzahrani, S.M., Al Doghaither, H.A., Al‑Ghafari, A.B., & Pushparaj, P.N. (2023). 5‑Fluorouracil and capecitabine therapies for the treatment of colorectal cancer (Review). Oncology Reports, 50, 175. https://doi.org/10.3892/or.2023.8612
MLA
Alzahrani, S. M., Al Doghaither, H. A., Al‑Ghafari, A. B., Pushparaj, P. N."5‑Fluorouracil and capecitabine therapies for the treatment of colorectal cancer (Review)". Oncology Reports 50.4 (2023): 175.
Chicago
Alzahrani, S. M., Al Doghaither, H. A., Al‑Ghafari, A. B., Pushparaj, P. N."5‑Fluorouracil and capecitabine therapies for the treatment of colorectal cancer (Review)". Oncology Reports 50, no. 4 (2023): 175. https://doi.org/10.3892/or.2023.8612