Adjuvant Xelox – pro

Folfox is the standard adjuvant chemotherapy for colon cancer. Capecitabine is also recommended for adjuvant therapy, but to replace contiunous infusion 5Fu rather than as a part of an oxalipatin containing regimen.

Xeloda is generally considered to be eqivalent to 5Fu and it is a 5FU pro-drug. A number of studies suggest that it is as effective as Folfox adjuvantly. A Phase III study showed the chemotherapy combination XELOX (Xeloda + oxaliplatin) to be as effective — in terms of progression-free survival (PFS) — as the current standard treatment, FOLFOX-4 (infused 5-FU/leucovorin + oxaliplatin), in the treatment of advanced (metastatic) colorectal cancer. For adjuvant therapy, we do now know that it is an effective regimen but it is not yet known whether it is as effective as Folfox. A large phase III XELOX-A study randomised patients between oxaliplatin/capecitabine (XELOX n = 937) or bolus 5-FU/LV (n = 924) in stage III colon cancer. data confirm that XELOX, a combination of Xeloda� (capecitabine) and oxaliplatin, is as safe as the current standard treatment of intravenous 5-fluorouracil/leucovorin (i.v. 5-FU/LV) in adjuvant colon cancer patients (post-surgery). Moreover, XELOX reduces the number of hospital visits by more than 60 percent compared to the current standard therapy, providing patients the freedom to live as normal a life as possible

Haller DG, Tabernero J, Maroun J, et alC, apecitabine Plus Oxaliplatin Compared With Fluorouracil and Folinic Acid as Adjuvant Therapy for Stage III Colon Cancer  J Clin Oncol. 2011;29:1465-1471

Schmoll HJ et al. Initial safety findings from XELOXA: a randomised phase III trial of capecitabine plus oxaliplatin vs. bolus 5-FU/LV as adjuvant therapy for patients (pts) with stage III colon cancer. Abstract 617 presented at the 13th European Cancer Conference, Paris, 2005.

I Chau and D Cunningham Adjuvant therapy in colon cancerwhat, when and how? Annals of Oncology 2006 17(9):1347-1359;

NCCN.ORG, Colon Cancer 2017

Capecitabine and Oxaliplatin in the Adjuvant Treatment of Stage III (Dukes’ C) Colon Cancer (TA100)  Technology Appraisal Guidance No. 100
http://www.mims.co.uk/Guidelines/882146/Capecitabine-Oxaliplatin-Adjuvant-Treatment-Stage-III-Dukes-C-Colon-Cancer-TA100/, 2009

Labianca R, Nordlinger B, Beretta GD, Brouquet A, Cervantes A; ESMO Guidelines Working Group.Primary colon cancer: ESMO Clinical Practice Guidelines for diagnosis, adjuvant treatment and follow-up.Ann Oncol. 2010 May;21 Suppl 5:v70-7.

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