Oral Chemotherapy

photo by Rhonda Baer, NCI

We tend to think of chemotherapy drugs as being administered intravenously, and the majority of them are. However, there are a number of chemotherapy drugs that can be taken orally, either in liquid or tablet/capsule form. The chief advantage of oral chemotherapy is the convenience—the patient can take their chemotherapy at home, without having to go to a clinic or hospital and sit through sometimes hours of IV infusions. Another great benefit to oral chemotherapy is that it gives the patient a degree of control over their own cancer care¹.

Availability of oral chemotherapy

There are currently over twenty chemotherapy drugs available in either capsule or tablet form to treat over ten different general forms of cancer², and it is an ever-growing list Those drugs include, but are not limited to, capecitabine, cyclophosphamide, chlorambucil, tamoxifen, idarubicin, vinorelbine, thalidomide, bicalutamide, flutamide, imatinib, prednisone, and imatinib; and the cancers they treat include various subtypes of leukemia and non-Hodgkin's lymphoma, some breast cancers, colon and colorectal cancers, some stomach cancers, lung cancers, ovarian cancer, Kaposi's sarcoma and multiple myeloma.

Drawbacks to oral chemotherapy

A drawback to oral chemotherapy is that, just like chemotherapy administered intravenously, oral chemo drugs have all the same side effects. This means that a patient can swallow a dose of chemotherapy and then suffer the same bouts of nausea or vomiting, except in this case he may vomit up his treatment dose. When this happens, it is necessary to contact one's oncologist immediately³.

Other drawbacks to oral chemotherapy include variable absorption, unpredictable and incomplete bioavailability, and uncertainty about patient compliance⁴.

References

1. Weingart SN et al. "NCCN Task Force Report: Oral chemotherapy." J Natl Compr Canc Netw 2008 Mar; 6 Suppl 3:S1-14. PMID: 18377852.
2. Pharmacy Times: Bringing Hope Home with Oral Antineoplastic Agents
3. American Cancer Society: Oral chemotherapy
4. McLeod HL, Evans WE. "Oral Cancer Chemotherapy: The Promise and the Pitfalls." Clin Cancer Res 1999 Oct;5(10):2669-71