Capecitabine + temozolomide

Capecitabine + temozolomide (commonly referred to as CAPTEM) is an oral combination chemotherapy regimen primarily used in the treatment of metastatic neuroendocrine tumors (NETs), including pancreatic neuroendocrine tumors. Capecitabine is a prodrug that is converted to 5-fluorouracil (5-FU) in vivo, which inhibits thymidylate synthase and disrupts DNA and RNA synthesis, leading to apoptosis. Temozolomide is an alkylating agent that methylates DNA at several sites, most notably the O6 position of guanine; this leads to DNA damage and cell death if not repaired by the enzyme MGMT. The combination exploits a synergistic mechanism where capecitabine depletes tumor MGMT levels, thereby enhancing the cytotoxic effect of temozolomide. This regimen has demonstrated activity in patients with advanced or metastatic NETs who have progressed on standard treatments[1][2][4].

Other names

CAPTEM