# Capecitabine + temozolomide (CAPTEM)

Source: https://onco.cc/drugs/capecitabine-temozolomide/  
OnCo record `capecitabine-temozolomide` (Treatment). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

CAPTEM (capecitabine plus temozolomide) is an all-oral chemotherapy pair that shrinks pancreatic neuroendocrine tumours in about a third of patients.

## Summary

ECOG-ACRIN E2211 (2018-2023): PFS 22.7 vs 14.4 months and higher response rate for CAPTEM versus temozolomide alone in pancreatic NETs; OS did not differ at final analysis. Used when tumour shrinkage is needed (bulky or symptomatic disease) and in grade 3 NETs. MGMT deficiency may predict response.

## Fields

- Kind: Treatment
- Status: established
- Last checked: 2026-09-07
- Modality: Oral cytotoxic regimen
- Mechanism: Fluoropyrimidine plus alkylating agent; capecitabine depletes MGMT, sensitising to temozolomide.
- Dosing: Oral; Capecitabine 750 mg/m² twice daily days 1-14, temozolomide 200 mg/m² days 10-14, every 28 days
- Toxicity (grade 3+): Neutropenia (grade 3-4) 13%; Thrombocytopenia (grade 3-4) 15%

## Sources

- ClinicalTrials.gov NCT01824875: ECOG-ACRIN E2211, temozolomide with or without capecitabine in advanced pancreatic neuroendocrine tumours (phase 2): https://clinicaltrials.gov/study/NCT01824875

## Connected records

- cancers: [Extrapulmonary neuroendocrine carcinoma](https://onco.cc/cancers/extrapulmonary-nec/), [Grade 3 well-differentiated neuroendocrine tumour](https://onco.cc/cancers/grade-3-net/), [Lung neuroendocrine tumours (typical and atypical carcinoid)](https://onco.cc/cancers/lung-net/), [Neuroendocrine tumours](https://onco.cc/cancers/neuroendocrine/), [Pancreatic neuroendocrine tumours](https://onco.cc/cancers/pancreatic-net/)
- technologies: [Cytotoxic chemotherapy](https://onco.cc/technologies/cytotoxic-chemotherapy/)
- drugs: [Capecitabine](https://onco.cc/drugs/capecitabine/), [Temozolomide](https://onco.cc/drugs/temozolomide/)
- companies: [ECOG-ACRIN Cancer Research Group](https://onco.cc/companies/ecog-acrin/)
- terms: [MGMT promoter methylation](https://onco.cc/terms/mgmt/)
- trials: [Lutetium 177Lu-Edotreotide Versus Best Standard of Care in Well-differentiated Aggressive Grade-2 and Grade-3 GastroEnteroPancreatic NeuroEndocrine Tumors (GEP-NETs) - COMPOSE](https://onco.cc/trials/nct04919226/)
- ideas: [Dose chemotherapy by muscle mass, not body surface area](https://onco.cc/ideas/idea-bio2-lean-mass-dosing/)

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