Study Of Capecitabine in Patients With Solid Tumours At a Tertiary Care Centre

Abstract

Background:Capecitabine, an orally administered fluoropyrimidine prodrug of 5-fluorouracil (5-FU), has become an integral component of systemic therapy for several solid malignancies because of its efficacy, favourable toxicity profile, and convenience of administration. Although its role has been extensively investigated in colorectal and breast cancers, real-world evidence regarding its effectiveness and tolerability across diverse solid tumours in the Indian population remains limited. This study aimed to evaluate the efficacy, safety, and tolerability of capecitabine in patients with solid tumours treated at a tertiary cancer care centre.
Methods: This observational study included adult patients with histopathologically confirmed solid malignancies who received capecitabine either as monotherapy or in combination with other anticancer modalities at the Department of Oncology in a tertiary care centre. Baseline demographic, clinicopathological, treatment, and laboratory data were recorded. Patients were prospectively followed to assess treatment response, adverse events, dose modifications, treatment interruptions, and survival outcomes. Tumour response was evaluated according to standard response assessment criteria (RECIST 1.1), while treatment-related toxicities were graded using the Common Terminology Criteria for Adverse Events. Statistical analyses were performed using appropriate descriptive and inferential methods, with a p-value <0.05 considered statistically significant.
Results: A total of 94 patients with solid malignancies were enrolled, with a median age of 48 years; 79% were female, and 84% had metastatic disease treated with palliative intent. Breast cancer was the most common malignancy (48.9%). Dose reduction due to toxicity was required in 72.3% of patients, while treatment discontinuation due to adverse events occurred in only 5.3%. Hand-foot syndrome (31.9%), anaemia (28.7%), and diarrhoea (21.3%) were the most frequent toxicities, with Grade 3/4 haematological toxicity observed in only 4.3%. Among the 78 evaluable patients, stable disease was achieved in 55.1%, partial response in 10.3%, and progressive disease in 34.6%. The highest disease control was observed in ovarian and cervical cancers, whereas head and neck cancers demonstrated the poorest response.
Conclusion: Capecitabine is an effective, safe, and well-tolerated therapeutic option for patients with a variety of solid malignancies in routine clinical practice. Its favourable toxicity profile, ease of oral administration, and acceptable treatment outcomes make it an attractive alternative to continuous intravenous fluoropyrimidine therapy. Early recognition and prompt management of treatment-related toxicities, particularly hand-foot syndrome and gastrointestinal adverse events, facilitate treatment continuation and optimize patient outcomes.