Abstract

Capecitabine is selectively converted from 5′-DFUR to 5-fluorouracil (5-FU) in tumours by thymidine phosphorylase (TP). We investigated the addition of 5-nitrouracil (5-NU), a TP inhibitor, into blood samples for precise measurements of plasma 5-FU concentrations. The plasma concentration of 5-FU was measured after capecitabine administration. Two samples were obtained at 1 or 2 h after capecitabine administration and 5-NU was added to one of each pair. Samples were stored at room temperature or 4 °C and 5-FU concentrations were measured immediately or 1.5 or 3 h later. The mean plasma 5-FU concentration was significantly higher at room temperature than at 4 °C (p < 0.001). The 5-FU concentration was significantly increased in the absence of 5-NU than in the presence of 5-NU (p < 0.001). The 5-FU change in concentration was greater in the absence of 5-NU, and reached 190% of the maximum compared with baseline. A significant interaction was found between temperature and 5-NU conditions (p < 0.001). Differences between the presence or absence of 5-NU were greater at room temperature than under refrigerated conditions. 5-FU plasma concentrations after capecitabine administration varied with time, temperature, and the presence or absence of 5-NU. This indicates that plasma concentrations of 5-FU change dependent on storage conditions after blood collection.

Highlights

  • Capecitabine is selectively converted from 5′-DFUR to 5-fluorouracil (5-FU) in tumours by thymidine phosphorylase (TP)

  • Incurred sample reanalysis (ISR) is the confirmation of the reproducibility of quantitative values by re-measurement of blood samples collected after the administration of test drugs to animals and humans[14]

  • The mean blood 5-FU concentration was significantly higher at room temperature storage than at 4 °C, irrespective of the presence of 5-NU, and the difference increased over time

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Summary

Introduction

Capecitabine is selectively converted from 5′-DFUR to 5-fluorouracil (5-FU) in tumours by thymidine phosphorylase (TP). Because capecitabine is predominantly converted to 5-FU in tumours, 5-FU levels in blood are typically measured after the oral administration of capecitabine without a metabolic inhibitor such as 5-NU. We analysed changes in 5-FU plasma concentration by using blood samples with the addition of 5-NU, which inhibits the conversion of 5′-DFUR to 5-FU.

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