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Capecitabine (Xeloda) is a tablet form of the chemotherapy fluorouracil. It is a backbone of treatment for bowel cancer and a standard option in advanced breast cancer.
Capecitabine was approved by the FDA in 1998 for anthracycline- and taxane-resistant metastatic breast cancer and later for adjuvant stage III colon cancer (X-ACT: disease-free survival at least equivalent to bolus fluorouracil and leucovorin), metastatic colorectal cancer, perioperative chemoradiotherapy for rectal cancer and, with docetaxel, for anthracycline-pretreated breast cancer. The EU authorised Xeloda in 2001; it is also approved there for gastric cancer. It is the oral partner in CAPOX and CAPTEM and in the CREATE-X post-neoadjuvant breast regimen. Hand-foot syndrome, diarrhoea and cardiotoxicity are the key toxicities, and DPD deficiency (DPYD variants) causes severe or fatal toxicity, so genotype-guided dosing is increasingly used. Warfarin interaction carries a boxed warning.
Converted in three steps, the last by thymidine phosphorylase enriched in tumours, to fluorouracil; FdUMP blocks thymidylate synthase and FUTP is incorporated into RNA.
1.Capecitabine slips into a pocket on its target.
Background: ADC sequencing, Antigen escape (antigen loss, lineage switch), BCG-unresponsive, Castration-resistant prostate cancer (CRPC), Circulating tumour DNA (ctDNA). Also on OnCo: Resistance: how tumours escape each drug class · Lines of therapy.
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Metastatic breast cancer resistant to paclitaxel and an anthracycline-containing chemotherapy regimen or resistant to paclitaxel and further anthracycline therapy is contraindicated
Accelerated approval on a surrogate endpoint, with a confirmatory trial required.
Metastatic breast cancer resistant to paclitaxel and an anthracycline-containing chemotherapy regimen or resistant to paclitaxel and further anthracycline therapy is contraindicated
Confirmed: the accelerated approval of 1998 converted to traditional approval 3.4 years after it was granted.
| Region | Year | Indication |
|---|---|---|
| US | 1998 | Metastatic breast cancer after anthracycline and taxane; later adjuvant and metastatic colorectal cancer, rectal chemoradiotherapy |
| EU | 2001 | Colorectal, gastric and breast cancer |
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The adjuvant finding sits uneasily beside BILCAP, on which NHS adjuvant capecitabine rests; in a mostly gallbladder population the benefit is not visible. ACTICCA-1 and ARTEMIDE-Biliary01 are the trials that can settle it.
ESPAC5 supports neoadjuvant chemotherapy over immediate surgery in borderline resectable disease and points to FOLFIRINOX as the regimen to build on.
Organ preservation became a plan rather than an accident: consolidation chemotherapy after chemoradiotherapy gives the best chance of keeping the rectum, and salvage surgery after regrowth does not appear to cost survival.
The second total neoadjuvant therapy schedule to change practice, and the one that shows the advantage is partly deliverability: chemotherapy given before an operation is completed by far more patients than chemotherapy given after one.
The first total neoadjuvant therapy trial to change practice in high-risk rectal cancer, and the schedule that makes organ preservation possible by giving the tumour months rather than weeks to respond.
This analysis is the evidence base for treating active HER2-positive brain metastases with a systemic regimen, sometimes deferring radiotherapy, and for tucatinib's brain-specific labelling.
Tucatinib-based therapy is the standard for HER2-positive disease with active brain metastases and a standard later-line option overall; it was the first trial to enrol progressing brain metastases and show a systemic drug helps them.
The European rulebook for what happens after a colon cancer operation, and the reason a patient with a T3 N1 tumour is now offered three months of chemotherapy rather than six.
Query for this drug: (TITLE:"Capecitabine" OR ABSTRACT:"Capecitabine" OR TITLE:"Xeloda" OR ABSTRACT:"Xeloda") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Capecitabine, not a curated reading list.
Shares Evaluation of the Preliminary Efficacy and Safety of DR30206 in Combination With Standard Therapy in Patients With Gastrointestinal Cancer, A Phase 2 Study of SSGJ-707 in Metastatic Colorectal Cancer Patients, A Study of SHR-1826 for Injection in Combination With Other Antitumor Therapies in Subjects With Solid Tumors, HR070803 in Combination With Oxaliplatin, 5-fluorouracil/LV Versus GX as Adjuvant Therapy for Pancreatic Cancer and the tag generic.
Shares A Study Comparing BL-B01D1 With Chemotherapy of Physician's Choice in Patients With Unresectable Locally Advanced, Recurrent, or Metastatic HR+HER2- Breast Cancer(PANKU-Breast01), Study of SKB264 for Locally Advanced, Recurrent or Metastatic HR+/HER2- Breast Cancer, A Study of TQB2930 for Injection Monotherapy or Combination Therapy in Patients With Recurrent/Metastatic Breast Cancer, Efficacy and Safety of PD-L1 Monoclonal Antibody Combined With Metronomic VEX in Advanced Triple-negative Breast Cancer and the tag generic.
Shares Trial Studying Chemotherapy in Nigerian Women With Triple Negative Breast Cancer, NordicTrip, a Translational Study of Preoperative Chemotherapy in TNBC, FLOT4-AIO: perioperative FLOT versus ECF/ECX for resectable gastric or gastro-oesophageal junction adenocarcinoma, FLOT4-AIO and the tag generic.
Shares LAP07: chemoradiotherapy versus continued chemotherapy for locally advanced pancreatic cancer controlled after four months of gemcitabine, LAP07, Roche / Genentech, Pancreatic ductal adenocarcinoma and the tag generic.
Shares Localised anal squamous cell carcinoma (stage I to III), Gastric & gastro-oesophageal junction cancer, Cytotoxic chemotherapy, Colorectal cancer and the tag generic.
Shares Chemotherapy roadmap: mustard gas → curative combinations → the warhead inside smarter drugs, Cytotoxic chemotherapy and the tag generic.
Shares Cytotoxic chemotherapy and the tag generic.
Shares Triple-negative breast cancer (TNBC) and the tag generic.