Xeloda and Avastin for colorectal cancer – pro

Xeloda is a 5FU prodrug that is now believed to produce effects similar to 5FU, although the equivalence has not been proven in all cancer types. The European Commission has approved oral chemotherapy Xeloda (capecitabine) for the treatment of metastatic colorectal cancer in combination with any chemotherapy in all lines of treatment with or without Avastin. While the FDA had not specifically approved Xeloda with Avastin, it indicated Avastin with 5 FU containing regimens and expert consensus is that multiple studies have shown that Xeloda is at least equivalent to 5FU in colorectal cancer. Xeloda and Avastin is also NCCN recommended but as Folfox/Avastin/Avastin or Xelox/Avastin. However, there are two phase II trials supporting Xeliri/Avastin and I referenced them.

Bradford R Hirsch and S Yousuf Zafar, Capecitabine in the management of colorectal cancer. Cancer Manag Res. 2011; 3: 79–89.

nccn.org, colon cancer, p.25

Hurwitz H, Kabbinavar F:
Bevacizumab Combined with Standard Fluoropyrimidine-Based Chemotherapy Regimens to Treat Colorectal Cancer.
Oncology 2005;69(Suppl.3):17-24

Bendell J, Yu D, Hurwitz H, et al. Capecitabine and oxaliplatin (XELOX) in combination with bevacizumab in the treatment of metastatic colorectal cancer: results of a phase II trial. Proceedings from the European Cancer Conference (ECCO 13). 2005. Paris, France. Abstract #667.
ALEXANDROS ARDAVANIS, PANTELEIMON KOUNTOURAKIS, IOANNIS MANTZARIS, SAVVOULA MALLIOU, DIMITRIOS DOUFEXIS, DESPINA SYKOUTRI, IOANNIS FRAGOS and GERASSIMOS RIGATOS, Bevacizumab Added to the Irinotecan and Capecitabine Combination for Advanced Colorectal Cancer: A Well-tolerated, Active and Convenient Regimen Anticancer Research September 1, 2008 vol. 28 no. 5B 3087-3092

Andrea Cercek, Leonard B. Saltz, Efficacy and safety of bevacizumab plus capecitabine and irinotecan regimen for metastatic colorectal cancer Journal Medical Oncology 1533-0028 Volume 7, Supplement 2 Pages S47-S51

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