title: XELOX followed by XELIRI or the reverse sequence in advanced colorectal cancer.
abstract: BACKGROUND
  Capecitabine has demonstrated high efficacy as first-line treatment for metastatic colorectal cancer (mCRC). In this non-randomized pilot study, we investigated the efficacy and safety of sequentially administered XELOX and XELIRI regimens or the reverse sequence in patients with advanced colorectal cancer.
  
  
  METHODS
  Entry criteria were histologically confirmed mCRC, ECOG performance status (PS) < or =2 and adequate bone marrow, renal and hepatic function. All patients consecutively received XELOX followed by XELIRI at disease progression or vice versa.
  
  
  RESULTS
  In multivariate analysis, independent prognostic factors with worse overall survival were: lower PS (p = 0.0001), multiple metastatic sites (p = 0.016) and high tumor grade. Higher serum levels of alkaline phosphatase and worse ECOG PS were associated with a shorter progression-free survival. Grade 3/4 mucositis, nausea/vomiting, grade 3/4 alopecia and grade 3 diarrhea were more frequent with XELIRI, whereas major toxicity events with XELOX were grade 3 neutropenia, thrombocytopenia and grade 2/3 neurotoxicity.
  
  
  CONCLUSIONS
  Capecitabine appears to be an acceptable alternative to continuous-infusion fluorouracil (FU)/leucovorin (LV) in combination therapy and offers an effective, but more convenient alternative to continuous infusion FU/LV in the first-line treatment of patients with mCRC.
authors.affiliation: Institute of Oncology, Istanbul University, Istanbul, Turkey. buraksakar@superonline.com
authors.forename: B
authors.initials: B
authors.lastname: Sakar
authors.forename: M
authors.initials: M
authors.lastname: Gumus
authors.forename: M
authors.initials: M
authors.lastname: Basaran
authors.forename: A
authors.initials: A
authors.lastname: Argon
authors.forename: Z
authors.initials: Z
authors.lastname: Ustuner
authors.forename: M A
authors.initials: MA
authors.lastname: Ustaoglu
authors.forename: S
authors.initials: S
authors.lastname: Saglam
authors.forename: N
authors.initials: N
authors.lastname: Guney
authors.forename: A N
authors.initials: AN
authors.lastname: Tenekeci
authors.forename: N F
authors.initials: NF
authors.lastname: Aykan
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002166:Camptothecin / Q000031:analogs & derivatives / Q000627:therapeutic use; D000069287:Capecitabine; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000473:pathology; D003841:Deoxycytidine / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use; D004334:Drug Administration Schedule; D005260:Female; D005472:Fluorouracil / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use; D006801:Humans; D000077146:Irinotecan; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D010071:Oxaloacetates; D010865:Pilot Projects; D016032:Randomized Controlled Trials as Topic
chemical_list: D010071:Oxaloacetates; D003841:Deoxycytidine; D000069287:Capecitabine; D000077146:Irinotecan; D007770:L-Lactate Dehydrogenase; D005472:Fluorouracil; D002166:Camptothecin