On prejudice and facts and choices

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Abstract
The use of anticancer agents as oral formulations is likely to increase over the coming years. Most of the new compounds will be developments of targeted agents. Classical anti-neoplastic drugs have been available as oral medications for some time. Some of these compounds are analogues of their i.v. counterparts. When used in combination regimens these agents are always under threat of being substituted by their i.v. sisters, at least if one of the combination partners needs to be given intravenously. The CMF regimen is a prominent example. Instead of giving cyclophosphamide p.o. as in the original schedule, it was often injected together with methotrexate and 5-fluorouracil [1]. Convenience of application and concern of potential non-compliance may have been reasons for this practice or it was the myth that an injection is always better than any tablet. Cancer patients are considered to be more compliant as they have ‘too much to lose’ [2]. Nevertheless, adherence to dose and schedule may be still a concern in case of a curatively intended therapy. Monochemotherapy and the adjuvant setting may be considered the ideal scenario for oral treatment to withstand the temptation of oncologists to use the intravenous alternative.