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Capecitabine is a prodrug which metabolizes in higher concentrations in tumour cells to the active drug 5-Fluorouracil (5-FU). This is because an enzyme, thymidine phosphorylase, required in the last step of conversion to 5-FU is present in higher concentrations in certain cancer cells of breast, colon and rectum. The upregulation of thymidine phosphorylase by docetaxel makes it a synergistic combination with capecitabine. Capecitabine provides a valuable option in patients of metastatic breast cancer who are resisitant to anthracycline and paclitaxel-containing regimens or those for whom anthracyclines are contraindicated.
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