From the Guidelines
Xeloda (capecitabine) for metastatic breast cancer is typically dosed at 1,250 mg/m² twice daily for 14 days, followed by a 7-day rest period, in 21-day cycles, as recommended by the NCCN guidelines 1.
Dosing and Administration
The dosing may be adjusted based on patient tolerance and response. For patients with reduced kidney function (creatinine clearance 30-50 mL/min), a reduced starting dose of 75% is recommended.
Side Effects and Monitoring
Common side effects include hand-foot syndrome, diarrhea, nausea, vomiting, and fatigue. Dose modifications are often necessary, with reductions to 75% or 50% of the original dose depending on the severity of side effects.
Treatment Duration
Treatment typically continues until disease progression or unacceptable toxicity occurs. Xeloda works as a prodrug that is converted to 5-fluorouracil in tumor tissue, where it interferes with DNA synthesis and cell division, making it effective against rapidly dividing cancer cells.
Key Considerations
Regular monitoring of complete blood counts, liver function, and kidney function is essential during treatment. The NCCN guidelines also recommend considering combination chemotherapy regimens, such as docetaxel and capecitabine, for certain patients with metastatic breast cancer 1. Some key points to consider when using Xeloda (capecitabine) for metastatic breast cancer include:
- The importance of monitoring for side effects and adjusting the dose as needed
- The potential for reduced kidney function to impact dosing
- The effectiveness of Xeloda (capecitabine) in combination with other chemotherapy agents
- The need for regular monitoring of complete blood counts, liver function, and kidney function during treatment. It's also worth noting that other studies have evaluated the efficacy of capecitabine in combination with other agents, such as lapatinib and neratinib, in patients with HER2-positive metastatic breast cancer 1.
From the FDA Drug Label
DOSAGE AND ADMINISTRATION is mentioned but the exact dose is not provided in the given text for metastatic breast cancer.
The FDA drug label does not answer the question.
From the Research
Doses for Xeloda (Capecitabine) in Metastatic Breast Cancer
- The dose of Xeloda (capecitabine) used in the treatment of metastatic breast cancer varies across studies, with reported doses including:
- 2500 mg/m(2)/d, twice daily for 2 weeks followed by a 1-week rest period, repeated every 3 weeks 2
- 1250 mg/m2 twice daily for 14 days followed by 7 days of rest 3
- 1000 mg/m2 twice daily for 14 days followed by 7 days of rest 3, 4
- 1000 mg/m2 orally, twice daily on days 1-14 of 21-day cycle 4
- 1000 mg/m2 orally, twice daily on days 1-7 and 15-21 of 28-day cycle 4
- A lower dose of capecitabine (1000 mg/m2) has been shown to have a better therapeutic profile and encouraging efficacy, with reduced toxicity compared to the higher dose (1250 mg/m2) 3
- The choice of dose and schedule may depend on individual patient factors, such as prior treatment and tolerance to chemotherapy 5, 4
- Studies have demonstrated the efficacy and safety of capecitabine in metastatic breast cancer, with overall response rates ranging from 16.0% to 57% 6, 2, 5, 3