Oral fluoropyrimidines in colorectal cancer : A door open to the future ?

Since its first use 40 years agO. 5-fluorouracil (5-FU) has become an unquestionable component of colorectal cancer treatment. It is also now well established that infusional 5-FU administration, in combination with leucovorin, is associated with better tolerance and at least equal efficacy than bolus administration. However, requiring catheter and infusion pumps, infusional 5-FU adminis- tration is costly, rather inconvenient for patients and potentially associated with morbidity, initiating subsequent oral chemothera- py development. To address intravenous 5-FU related issues, oral fluoropyrimidines have been developed such as capecitabine, pref- erentially converted to 5-FU into tumour cells, and UFT, able of bypassing intestinal dihydropyrimidine deshydrogenase. We dis- cuss in this article current oral fluoropyrimidines achievements in colorectal cancer management. (Acta gastroenterol. belg., 2004, 67, 331-333).