Caspofungin Acetate Injection and Fluorouracil

• Generic Name: caspofungin
• Dosage Forms: injection, powder, lyophilized, for solution
• Other Brand Names: Cancidas

Caspofungin is an antifungal medicine that fights infections caused by fungus.

Caspofungin is used to treat fungal infections of the stomach, lungs, esophagus, or other internal body areas.

Caspofungin may also be used for purposes not listed in this medication guide.

• Generic Name: fluorouracil
• Dosage Forms: n.a.
• Other Brand Names: Adrucil

Principally for GI, breast, and head and neck cancers.

Palliative treatment of carcinoma of the colon, rectum, anus, stomach, biliary tract, esophagus, and pancreas that is not amenable to surgery or irradiation.

Adjunct to surgery for the treatment of various solid tumors (e.g., adenocarcinoma of the colon, rectal carcinoma).

Drug of choice (combined with leucovorin) as an adjunct to surgery for colorectal cancer.

Drug of choice (combined with leucovorin and other drugs [e.g., irinotecan, oxaliplatin]) for metastatic colorectal cancer.

Combination fluorouracil/leucovorin regimens have replaced fluorouracil monotherapy regimens as adjuvant therapy for stage III disease.

Weekly schedule of fluorouracil/leucovorin (high-dose leucovorin or Roswell Park regimen) has equal efficacy as monthly schedule (low-dose or Mayo Clinic schedule), but the weekly schedule is a preferred regimen for adjuvant therapy because of ease of use and less toxicity. (See Colorectal Cancer under Dosage and Administration.)

Bimonthly, continuous IV infusion schedule of fluorouracil/leucovorin (LV5FU2 or deGramont regimen) also evaluated as adjuvant therapy and shown to be safer than direct IV injection regimen of these drugs. Simplified version of this regimen also evaluated. (See Colorectal Cancer under Dosage and Administration.)

Role of regional adjuvant therapy (e.g., portal vein or hepatic artery infusion) for liver metastases requires further elucidation.

Leucovorin and levoleucovorin enhance cytotoxicity, potentiate fluorouracil antineoplastic activity, and improve response for palliative advanced colorectal carcinoma treatment; designated an orphan drug by FDA for use with leucovorin for metastatic colorectal adenocarcinoma.

Leucovorin and levoleucovorin may potentiate risk of fluorouracil GI toxicity (e.g., diarrhea, nausea, stomatitis, vomiting) and myelosuppression.

Drug of choice for treatment of esophageal cancer.

Has been used alone and in combination therapy (e.g., with cisplatin) for the treatment of localized or advanced esophageal cancer.

Drug of choice (with or without leucovorin and/or other drugs [e.g., cisplatin, epirubicin]) for treatment of gastric cancer.

Drug of choice (e.g., combined with mitomycin or cisplatin) for treatment of anal cancer.

Drug of choice as adjunct to surgery and for localized unresectable pancreatic cancer.

Drug of choice (with or without leucovorin) for treatment of biliary tract cancer.

Drug of choice combined with other drugs (e.g., cyclophosphamide and doxorubicin or methotrexate) as an adjunct to surgery and for metastatic breast cancer.

Palliative treatment of carcinoma of the breast not amenable to surgery or irradiation.

Adjunct to surgery, may improve outcome.

Has been used most extensively with cyclophosphamide and methotrexate, and is considered a regimen of choice.

Drug of choice combined with cisplatin for head and neck cancer.

In combination chemotherapy for metastatic or recurrent squamous cell carcinoma of the head and neck.

Has been used in combination chemotherapy with radiation therapy for palliative treatment of unresectable locally advanced head and neck cancer, and for larynx preservation in locally advanced laryngeal or hypopharyngeal cancer.

Used in combination with docetaxel and cisplatin as induction therapy prior to radiotherapy or chemoradiotherapy in the treatment of locally advanced squamous cell carcinoma of the head and neck.

Drug of choice combined with other drugs (e.g., cisplatin) for treatment of locally advanced cervical cancer.

In combination with cisplatin concurrently with radiation therapy for invasive cervical cancer.

Metastatic or recurrent cervical cancer.

Has been used alone or in combination regimens for the treatment of metastatic renal cell carcinoma.

Drug of choice for treatment of carcinoid tumors.

Second-line therapy in the treatment of ovarian epithelial cancer, including platinum-refractory disease. Also, cancers of the liver (e.g., hepatoblastoma).