Capecitabine is commonly substituted for conventional 5-fluorouracil chemotherapy based on evidence of the efficacy equivalence of these two drugs and the lack of an increase in overall toxic effects when capecitabine is used. This Review summarizes why there may not be a universally applicable dose for capecitabine because of interpatient differences in basic physiology, pharmacogenomics and diet. The authors also discuss which of these factors contribute to the inter-regional geographical variation in capecitabine toxicity, and the reasons for modifying the starting dose.
- Rachel Midgley
- David J Kerr