5-fluorouracil

5-Fluorouracil

5-Fluorouracil (5-FU) is a chemotherapy medication used to treat various types of cancer. It is a pyrimidine analog, which means it mimics the structure of pyrimidine, a building block of DNA and RNA. By interfering with the synthesis of DNA and RNA, 5-FU inhibits the growth of cancer cells.

Mechanism of Action

5-Fluorouracil works primarily by inhibiting the enzyme thymidylate synthase, which is crucial for the synthesis of thymidine, a nucleotide necessary for DNA replication. Without thymidine, cancer cells cannot properly replicate their DNA, leading to cell death. Additionally, 5-FU is incorporated into RNA, disrupting normal RNA processing and function.

Clinical Uses

5-Fluorouracil is used in the treatment of several types of cancer, including:

• Colorectal cancer
• Breast cancer
• Gastric cancer
• Pancreatic cancer
• Esophageal cancer
• Head and neck cancer

It is often used in combination with other chemotherapy agents to enhance its effectiveness.

Administration

5-FU can be administered in several ways, including:

• Intravenous injection
• Continuous infusion
• Topical application for certain skin cancers

The method of administration depends on the type and stage of cancer being treated.

Side Effects

Common side effects of 5-FU include:

• Nausea and vomiting
• Diarrhea
• Mucositis (inflammation of the mucous membranes)
• Myelosuppression (decreased production of blood cells)
• Hand-foot syndrome (redness, swelling, and pain on the palms of the hands and soles of the feet)

Patients receiving 5-FU are monitored closely for these side effects, and supportive care is provided to manage them.

Pharmacogenomics

The effectiveness and toxicity of 5-FU can be influenced by genetic variations in the enzyme dihydropyrimidine dehydrogenase (DPD), which is responsible for metabolizing 5-FU. Patients with DPD deficiency may experience severe toxicity and require dose adjustments.

History

5-Fluorouracil was first synthesized in the 1950s and has since become a cornerstone in the treatment of various cancers. Its development marked a significant advancement in chemotherapy.

Research and Development

Ongoing research is focused on improving the efficacy and reducing the toxicity of 5-FU. This includes the development of new formulations and combination therapies.

Also see

• Chemotherapy
• Cancer treatment
• Thymidylate synthase
• Dihydropyrimidine dehydrogenase