Abstract |
The combination of capecitabine ( Xeloda) and oxaliplatin ( Eloxatin), or XELOX, is an effective and safe approach to the treatment of advanced colorectal cancer, with the potential advantage of convenience over standard combination regimens. In a large multicenter phase II trial for patients with metastatic colorectal cancer (N = 96), first-line treatment with oral capecitabine at 1,000 mg/m2 twice daily for 14 days and oxaliplatin at 130 mg/m2 by 2-hour infusion on day 1 every 21 days produced objective response in 55% of patients and stable disease (greater than 3 months) in a further 32%. Preliminary data indicate a median progression-free survival of 7.6 months (with 14% of patients still having not progressed) and median survival of over 16 months (with 59% of patients still alive); the 1-year survival rate was 72%. Grade 3 or 4 toxicity was relatively infrequent; in particular, grade 3 hand-foot syndrome occurred in just 3% of patients and severe neutropenia in only 6%. Treatment delivery was highly successful, with a median of 10 cycles being administered (range: 1-23 cycles). Both efficacy and safety outcomes with the XELOX combination compare well with those observed with infusional fluorouracil (5-FU)/ leucovorin plus oxaliplatin (FOLFOX4) in first-line treatment for advanced disease. However, 3-weekly XELOX requires less time in hospital and is simpler than the 2-weekly standard FOLFOX4 regimen. Phase III trials comparing XELOX with infusional 5-FU/ leucovorin/ oxaliplatin are ongoing.
|
Authors | Christopher Twelves |
Journal | Oncology (Williston Park, N.Y.)
(Oncology (Williston Park))
Vol. 16
Issue 12 Suppl No 14
Pg. 23-6
(Dec 2002)
ISSN: 0890-9091 [Print] United States |
PMID | 12520636
(Publication Type: Journal Article, Review)
|
Chemical References |
- Organoplatinum Compounds
- Prodrugs
- Oxaliplatin
- Deoxycytidine
- Capecitabine
- Leucovorin
- Fluorouracil
|
Topics |
- Administration, Oral
- Antineoplastic Combined Chemotherapy Protocols
(therapeutic use)
- Capecitabine
- Clinical Trials as Topic
- Colorectal Neoplasms
(drug therapy, pathology)
- Deoxycytidine
(administration & dosage, adverse effects, analogs & derivatives, pharmacology)
- Disease-Free Survival
- Drug Administration Schedule
- Fluorouracil
(administration & dosage)
- Hospitalization
- Humans
- Leucovorin
(administration & dosage)
- Multicenter Studies as Topic
- Neutropenia
(chemically induced)
- Organoplatinum Compounds
(administration & dosage, adverse effects, pharmacology)
- Oxaliplatin
- Peripheral Nervous System Diseases
(chemically induced)
- Prodrugs
(administration & dosage, adverse effects, pharmacology)
|