Biweekly XELOX (capecitabine and oxaliplatin) as first-line treatment in elderly patients with metastatic colorectal cancer

• Published in: Journal of geriatric oncology 2013-04, Vol.4 (2), p.114-121
• Main Authors: Grande, Carlos, Quintero, Guillermo, Candamio, Sonia, París Bouzas, Lorena, Villanueva, María José, Campos, Begoña, Gallardo, Elena, Alvarez, Elena, Casal, Joaquín, Mel, José Ramón
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Camptothecin - administration & dosage; Camptothecin - analogs & derivatives; Capecitabine; Colorectal Neoplasms - drug therapy; Colorectal Neoplasms - mortality; Colorectal Neoplasms - pathology; Comorbidity; Creatinine - analysis; Deoxycytidine - administration & dosage; Deoxycytidine - adverse effects; Deoxycytidine - analogs & derivatives; Dose-Response Relationship, Drug; Elderly; Female; Fluorouracil - administration & dosage; Fluorouracil - adverse effects; Fluorouracil - analogs & derivatives; Hematology, Oncology and Palliative Medicine; Humans; Internal Medicine; Male; Metastatic colorectal cancer; Oxaliplatin; XELOX
• ISSN: 1879-4068; 1879-4076
• DOI: 10.1016/j.jgo.2013.01.001

Abstract Objective The combination of oxaliplatin and oral capecitabine (XELOX) has shown to be an active regimen in metastatic colorectal cancer (MCRC). However, the experience with XELOX in elderly patients is limited. This study aimed to evaluate the efficacy and safety of XELOX as first-line treatment in elderly patients with MCRC. Patients and Methods Patients aged ≥ 70 years with previously untreated MCRC received oxaliplatin 85 mg/m2 on day 1, every 2 weeks plus capecitabine 1000 mg/m2 (or capecitabine 750 mg/m2 if creatinine clearance was 30–50 mL/min) twice daily on days 1–7, every 2 weeks. Treatment was continued until progression, intolerable toxicity, or for a maximum of 12 cycles. Results Thirty-five patients were enrolled. Median age was 78 years (range, 70–83). Patients received a median of 11 cycles of treatment. The objective response rate (ORR) was 49% and the tumor control rate was 86%. Median time to progression and overall survival were 8.6 (95% CI: 5.5–11.7) and 15.5 (95% CI: 9.6–21.3) months, respectively. Toxicities were generally mild to moderate. Major grade 1–2 toxicities were asthenia (40%), nausea (43%), and diarrhea (40%). No grade 4 toxicity was detected and grade 3 toxicities were reported in 17% of patients. There was no treatment-related death. Conclusion Our findings show that the biweekly XELOX regimen represents an effective and tolerable first-line treatment option for elderly patients with MCRC.