J Korean Med Assoc.  2007 May;50(5):464-470. 10.5124/jkma.2007.50.5.464.

Oral Chemotherapy

• Kim WJ

• KMID: 1958198
• DOI: http://doi.org/10.5124/jkma.2007.50.5.464

Abstract

Most cancer patients present with advanced disease at diagnosis, and a large percentage of those diagnosed with early-stage disease eventually experience recurrence of metastatic disease. Although chemotherapy has recently produced promising results and some progress has been made in the treatment of locally advanced and advanced disease, treatment outcomes and adverse profiles for advanced cancers are still very disappointing. Thus, clinical research on new treatment strategies is warranted. Traditionally, chemotherapy is given by injection. Oral chemotherapy has been developed as a more convenient method of treatment for patients, without the need for cumbersome and uncomfortable injection devices. As oral chemotherapy is taken in the form of a tablet or capsule, it does not need to be injected into the body like other types of chemotherapy. There are many types of oral chemotherapy available for the treatment of different types of cancers. For many patients who are prescribed oral chemotherapy, taking their medication at home is one of the main advantages, as it allows them to live their daily lives without the disruption by hospital visits. In addition, some oral chemotherapy can be more effective and have fewer side effects than conventional chemotherapy. The growing availability of effective oral chemotherapy, especially the new class of 'targeted biologic therapies', is one of the wonderful recent advances in cancer care, as it has given cancer patients unprecedented convenience compared to intravenous infusion therapy. Here, newly developed oral chemotherapy agents and possible approaches to overcome these challenges are discussed.

Keyword

Cancer; Chemotherapy; Oral

MeSH Terms

Diagnosis
Drug Therapy*
Humans
Infusions, Intravenous
Recurrence

Figure

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  Figure 1 Treatment algorithm for peripheral solid tumor.

Reference

1. Curtiss FR. Pharmacy benefit spending on oral chemotherapy drugs. J Manag Care Pharm. 2006. 12:570–577.

2. U.S. Food and Drug Administration. Available at: http://www.accessdata.fda.gov/scripts/cder/drugsatfda/index.cfm.

3. Medscape. Available at: http://search.medscape.com/drugreference-search?cid=med.

4. MedlinePlus. Available at: http://www.nlm.nih.gov/medlineplus/druginformation.html.

5. Kantarjian HM, Talpaz M, O'Brien S, Smith TL, Giles FJ, Faderl S, Thomas DA, Garcia-Manero G, Issa JP, Andreeff M, Kornblau SM, Koller C, Beran M, Keating M, Rios MB, Shan J, Resta D, Capdeville R, Hayes K, Albitar M, Freireich EJ, Cortes JE. Imatinib mesylate for Philadelphia chromosome-positive, chronic-phase myeloid leukemia after failure of interferon-alpha: follow-up results. Clin Cancer Res. 2002. 8:2177–2187.

6. Herbst RS, Giaccone G, Schiller JH, Natale RB, Miller V, Manegold C, Scagliotti G, Rosell R, Oliff I, Reeves JA, Wolf MK, Krebs AD, Averbuch SD, Ochs JS, Grous J, Fandi A, Johnson DH. Gefitinib in combination with paclitaxel and carboplatin in advanced non-small-cell lung cancer: a phase III trial-INTACT 2. J Clin Oncol. 2004. 22:785–794.

7. Giaccone G, Herbst RS, Manegold C, Scagliotti G, Rosell R, Miller V, Natale RB, Schiller JH, Von Pawel J, Pluzanska A, Gatzemeier U, Grous J, Ochs JS, Averbuch SD, Wolf MK, Rennie P, Fandi A, Johnson DH. Gefitinib in combination with gemcitabine and cisplatin in advanced non-small-cell lung cancer: a phase III trial-INTACT 1. J Clin Oncol. 2004. 22:777–784.

8. LaRosa JC, Grundy SM, Waters DD, Shear C, Barter P, Fruchart JC, Gotto AM, Greten H, Kastelein JJ, Shepherd J, Wenger NK. Intensive lipid lowering with atorvastatin in patients with stable coronary disease. N Engl J Med. 2005. 352:1425–1435.

9. Ratain MJ, Eisen T, Stadler WM, Flaherty KT, Kaye SB, Rosner GL, Gore M, Desai AA, Patnaik A, Xiong HQ, Rowinsky E, Abbruzzese JL, Xia C, Simantov R, Schwartz B, O'Dwyer PJ. Phase II placebo-controlled randomized discontinuation trial of sorafenib in patients with metastatic renal cell carcinoma. J Clin Oncol. 2006. 24:2505–2512.

10. Motzer RJ, Michaelson MD, Redman BG, Hudes GR, Wilding G, Figlin RA, Ginsberg MS, Kim ST, Baum CM, DePrimo SE, Li JZ, Bello CL, Theuer CP, George DJ, Rini BI. Activity of SU11248, a multitargeted inhibitor of vascular endothelial growth factor receptor and platelet-derived growth factor receptor, in patients with metastatic renal cell carcinoma. J Clin Oncol. 2006. 24:16–24.

11. Motzer RJ, Rini BI, Bukowski RM, Curti BD, George DJ, Hudes GR, Redman BG, Margolin KA, Merchan JR, Wilding G, Ginsberg MS, Bacik J, Kim ST, Baum CM, Michaelson MD. Sunitinib in patients with metastatic renal cell carcinoma. JAMA. 2006. 295:2516–2524.

12. CC-5013 MM 0017: a multicenter, randomized, parallel-group, double-blind, placebo-controlled study of CC-5013 plus dexamethasone versus dexamethasone alone in previously treated subjects with multiple myeloma. Clin Adv Hematol Oncol. 2003. 1:189–190.