Capecitabine chemoprevention may be considered for the treatment of precancerous and cancerous lesions among patients at high risk for developing skin cancers, including those with a history of multiple squamous cell carcinomas (SCC) and solid organ transplant recipients, according to findings from a recent systematic review published in JAMA Dermatology.
The researchers analyzed articles published between January 1, 1998, and December 31, 2019, that assessed the use of capecitabine for the treatment and prevention of actinic keratoses (AKs), basal cell carcinomas (BCCs), and SCCs. Included in the analysis were a total of 16 articles: eight case reports describing the inflammation of AKs in patients with solid organ cancer treated with capecitabine, one case report and one case series that assessed the use of capecitabine for the treatment of advanced or widespread cutaneous SCCs, and three case reports and three case series that investigated the use of capecitabine to prevent the development of SCC in solid organ transplant recipients.
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Overall, two studies found significant reduction in the rate of SCC incidence during treatment with capecitabine compared with before treatment. However, adverse effects limited the duration of chemoprevention in several patients. The most common of these included fatigue, nausea, vomiting, diarrhea, elevated creatinine level, hand-foot syndrome, hyperuricemia, weight loss, anemia, and cardiomyopathy.
“Capecitabine treatment may be associated with a decrease in the incidence of SCCs in [solid organ transplant recipients],” the researchers concluded, also noting that capecitabine may be associated with decreases in the incidence of AK and BCC. “However, practitioners must weigh this benefit against the risk of adverse effects for each patient individually. Further investigation with a prospective clinical trial is warranted,” they added.
Schauder DM, Kim J, Nijhawan RI. Evaluation of the use of capecitabine for the treatment and prevention of actinic keratoses, squamous cell carcinoma, and basal cell carcinoma: a systematic review. JAMA Dermatol. Published online July 08, 2020. doi:10.1001/jamadermatol.2020.2327