What is the recommended use and dosage of Xeloda (capecitabine) for cancer treatment?

From the Guidelines

Xeloda (capecitabine) is recommended at a dose of 825 mg/m² twice per day, orally administered on days of radiation, in combination with mitomycin-C (MMC) for the treatment of stage I-III anal cancer. This recommendation is based on the latest guidelines from the American Society of Clinical Oncology (ASCO) 1. The use of capecitabine as an alternative to fluorouracil (FU) is recognized by the Expert Panel, despite the lack of randomized controlled trials (RCTs) on the combination of MMC and capecitabine 1.

Key considerations for the use of Xeloda in cancer treatment include:

• Combination with MMC for stage I-III anal cancer 1
• Alternative to FU, with a recommended dose of 825 mg/m² twice per day 1
• Administration on days of radiation 1
• Monitoring for toxicities, such as hand-foot syndrome, diarrhea, and myelosuppression 1
• Dose adjustments for patients with renal impairment [not specified in the provided evidence, but generally recommended in clinical practice]

It is essential to note that the recommended dose and schedule of Xeloda may vary depending on the specific clinical context and patient population 1. Therefore, healthcare providers should consult the latest guidelines and clinical evidence to ensure optimal treatment outcomes for their patients.

From the FDA Drug Label

DOSAGE AND ADMINISTRATION The recommended dose of XELODA is 1250 mg/m2 administered orally twice daily (morning and evening; equivalent to 2500 mg/m2 total daily dose) for 2 weeks followed by a 1-week rest period given as 3-week cycles. In combination with docetaxel, the recommended dose of XELODA is 1250 mg/m2 twice daily for 2 weeks followed by a 1-week rest period, combined with docetaxel at 75 mg/m2 as a 1-hour intravenous infusion every 3 weeks.

The recommended use and dosage of Xeloda (capecitabine) for cancer treatment is 1250 mg/m2 orally twice daily for 2 weeks followed by a 1-week rest period, given as 3-week cycles.

• The dose may need to be individualized to optimize patient management.
• Dose modification may be necessary to manage adverse events, with recommendations provided in the dose reduction schedule 2. Key points:
• Total daily dose: 2500 mg/m2
• Administration: orally twice daily (morning and evening)
• Cycle duration: 3 weeks (2 weeks of treatment + 1 week of rest)
• Combination with docetaxel: 1250 mg/m2 twice daily for 2 weeks + docetaxel at 75 mg/m2 every 3 weeks 2.

From the Research

Recommended Use and Dosage of Xeloda (Capecitabine)

The recommended use and dosage of Xeloda (capecitabine) for cancer treatment are as follows:

• Xeloda is approved for use in metastatic colorectal cancer and metastatic breast cancer 3, 4, 5, 6.
• The dose of capecitabine approved by the US Food and Drug Administration (FDA) for both metastatic colorectal and breast cancer is 1250 Mg/M2 given orally twice per day, usually separated by 12 hours for the first 2 weeks of every 3-week cycle 3.
• Capecitabine is also approved for use as a single agent in metastatic breast cancer patients who are resistant to both anthracycline- and paclitaxel-based regimens or in whom further anthracycline treatment is contraindicated 3, 4.
• In combination with docetaxel, capecitabine is used after failure of prior anthracycline-based chemotherapy 3, 4.

Efficacy of Xeloda (Capecitabine)

The efficacy of Xeloda (capecitabine) in cancer treatment is supported by several studies:

• Capecitabine has shown varying degrees of efficacy with acceptable tolerability in numerous cancers, including prostate, renal cell, ovarian, and pancreatic cancers 3.
• In metastatic breast cancer, capecitabine has been shown to be effective as monotherapy and in combination with other agents, including docetaxel 4, 6.
• In metastatic colorectal cancer, capecitabine has been shown to be effective as monotherapy and in combination with other agents, including oxaliplatin and irinotecan 3, 5.

Adverse Effects of Xeloda (Capecitabine)

The adverse effects of Xeloda (capecitabine) are as follows:

• The most common dose-limiting adverse effects associated with capecitabine monotherapy are hyperbilirubinemia, diarrhea, and hand-foot syndrome 3.
• Myelosuppression, fatigue and weakness, abdominal pain, and nausea have also been reported 3.
• Capecitabine has been reported to increase serum phenytoin levels and the international normalized ratio in patients receiving concomitant phenytoin and warfarin, respectively 3.