Xeloda for hepatocellular cancer – pro

Metastatic hepatocellular carcinoma (HCC) is a difficult problem to treat. Nexavar has recently been FDA approved for HCC. Among other options are older drugs, such as capecitabine (Xeloda).  A pilot study showed that capecitabine (1000 mg/m2 twice daily for 14 days every 21 days) achieved a response rate of 19% in patients with advanced biliary cancer . A larger review showed that at 2,000 mg/m2/d, capecitabine produced a 50% response rate and up to a 70% 1-year overall survival rate in hepatobiliary cancer patients. A phase II trial of gemcitabine and capecitabine in patients with unresectable or metastatic cholangiocarcinoma is being conducted by the Southwest Oncology Group (SWOG). The starting dose of capecitabine is 650 mg/m2 bid, which is subsequently reduced to 162 mg/m2, based on toxicity and renal function. The starting dose of gemcitabine is 1,000 mg/m2, which is reduced to 250 mg/m2. There as well trials of Xeloda with cisplatin and oxaliplatin, Avastin and other drugs. Xeloda requires more study singly or in combination.

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YUN YEN, MD et al, Gallbladder and Biliary Tract Carcinoma: A Comprehensive Update, Part 2 Oncology. Vol. 18 No. 8 July 1, 2004

Knox JJ, Hedley D, Oza A: Phase II trial of gemcitabine plus capecitabine in patients with advanced or metastatic adenocarcinoma of the biliary tract (abstract). Proc Am Soc Clin Oncol 22: 313, 1274, 2003.

T. W. Kim , H. M. Chang , H. J. Kang , J. R. Lee , M. H. Ryu , J. H. Ahn , J. H. Kim , J. S. Lee , and Y. K. Kang  Phase II study of capecitabine plus cisplatin as first-line chemotherapy in advanced biliary cancer  Ann Oncol 14: 1115-1120.


C Hsu etal, Efficacy and tolerability of bevacizumab plus capecitabine as first-line therapy in patients with advanced hepatocellular carcinoma. British Journal of Cancer 102, 981-986 (16 March 2010)

Rose, M. G., Yen, Y., So, S., Saif, M. W., Chu, E., Liu, S., Jiang, Z., Foo, A., Tilton, R., Cheng, Y.
Phase I/II study of PHY906/capecitabine in hepatocellular carcinoma
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