Uridine triacetate: the saviour in waiting, finally arrives

Abstract

Cancer of the gastrointestinal tract is one of the very common solid cancers. Colorectal cancer is one of the types in which the anticancer drug 5-fluorouracil (5-FU) or its prodrug capecitabine is used. Toxicity to 5-FU or capecitabine is a common occurrence in patients receiving it. In such conditions, dose reduction or drug discontinuation for some time was the only way out apart from some supportive measures. An exhaustive search was always on to find a suitable antidote for the toxicity. The molecule uridine triacetate was studied for a long to be used in this condition. A systematic search of the existing literature about uridine triacetate was done with available sources like PubMed, Google Scholar, etc. Information about uridine triacetate was assembled and processed from these sources. Uridine triacetate was given orphan drug status for this indication a few years back. After a clinical trial, the drug was finally approved by the US FDA on December 11, 2015, for use in case of toxicity to 5- 5-FU or capecitabine. Well, stat Therapeutics has been marketing the drug under the trade name of Vistogard. Uridine triacetate works by preventing the toxic metabolite of 5-FU from entering and establishing itself in the RNA framework, by competing with the toxic metabolites. It is a relatively safe drug with minimal side effects. This article discusses the molecule uridine triacetate, its structure, metabolism, and kinetics in the body, the why and how of its action, and finally the results and findings of the clinical trial done with it.