Capecitabine treatment patterns in patients with gastroesophageal cancer in the United States

AIM： To assess the use of capecitabine-based therapy and associated complication rates in patients with gastroesophageal cancer （GEC） in a real-world treat- ment setting. METHODS： Patients with claims between 2004 and 2005 were identified from the Thomson Reuters MarketScan databases. Capecitabine regimens were compared with 5-fluorouracU （5-FU） and other chemotherapy regimens, and were stratified by treatment setting. RESULTS： We identified 1013 patients with GEC： approximately half had treatment initiated with a 5-FU regimen, whereas 11% had therapy initiated with a capecitabine regimen. The mean capecitabine dose overall was 2382 ± 1118 mg/d, and capecitabine was used as monotherapy more often than in combination. Overall, 5-FU regimens were the most common treat- ment option in neoadjuvant and adjuvant settings, while other non-capecitabine regimens were used more widely in first- and second-line settings. The overall unadjusted complication rate for capecitabine regimens was about half of that seen with 5-FU regimens. In multivariate analyses, capecitabine recipients had a 51% （95% CI： 26%-81%） lower risk of developing any complication than 5-FU recipients did. The risk of developing bone marrow, constitutional, gastrointestinal tract, infectious, or skin complications was lower with capecitabine therapy than with 5-FU.CONCLUSION： Capecitabine appeared to have a favorable side effect profile compared with 5-FU, which indicates that it may be a treatment option for GEC.

AIM:To assess the use of capecitabine-based therapy and associated complication rates in patients with gastroesophageal cancer(GEC)in a real-world treatment setting. METHODS:Patients with claims between 2004 and 2005 were identified from the Thomson Reuters MarketScan databases.Capecitabine regimens were compared with 5-fluorouracil(5-FU)and other chemotherapy regimens,and were stratified by treatment setting. RESULTS:We identified 1013 patients with GEC:approximately half had treatment initiated with a 5-FU regimen,whereas 11%had therapy initiated with a capecitabine regimen.The mean capecitabine dose overall was 2382±1118 mg/d,and capecitabine was used as monotherapy more often than in combination. Overall,5-FU regimens were the most common treatment option in neoadjuvant and adjuvant settings, while other non-capecitabine regimens were used more widely in first-and second-line settings.The overall unadjusted complication rate for capecitabine regimens was about half of that seen with 5-FU regimens.In multivariate analyses,capecitabine recipients had a 51%(95%CI:26%-81%)lower risk of developing any complication than 5-FU recipients did.The risk of developing bone marrow,constitutional,gastrointestinal tract,infectious,or skin complications was lowerwith capecitabine therapy than with 5-FU.CONCLUSION:Capecitabine appeared to have a favorable side effect profile compared with 5-FU,which indicates that it may be a treatment option for GEC.