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Xeloda (Capecitabine)
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1 Oral Oncology Products: Barriers to Successful Adoption
Oncology Issues 17(1):26-27, 2002. Oral agents are easy to use and offer the promise of less frequent visits to the physician's office. This promise is not trivial, especially as we have come to realize that many forms of cancer may be managed with these drugs. Still, oral oncology therapies are encountering a number of obstacles, including concerns about patient compliance and reimbursement. Will patients take all the medicine they should and take them on schedule? Will patients tell their doctors in a timely manner about the side effects they are having? Will insurance companies pay for oral medications so patients can afford them? As yet, these questions remain unanswered, and consequently the use of oral cancer agents has been limited.
http://www.medscape.com/viewarticle/425250 |
altman23
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1a "Oral Therapy: A Move Towards Convenience for Metastatic Colorectal Cancer"
In this edition of CancerTalk, leading colorectal cancer researcher, Dr. Robert Wolff from The University of Texas M. D. Anderson Cancer Center along with colon cancer patient Wayne Armentrout talk about how current therapies are changing the standard of treatment for metastatic disease and how that trend is heading towards oral administration, taking a pill in the comfort of your own home rather than spending valuable time at the clinic connected to an IV or carrying around a pump.
http://www.healthtalk.com/ctalk/edition38/ |
altman23
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2 Roche Xeloda Page
http://www.xeloda.com/web/site_map.asp |
altman23
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3 Steve Dunn's Cancerguide
Helpful information on how to research the clinical literature, how to interpret clinical trial results, how to read a survival curve, etc.
http://www.cancerguide.org/mainmenu.html |
altman23
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5-fluorouracil/leucovorin versus capecitabine in patients with stage III colon cancer.
PMID: 11273590 Semin Oncol 2001 Feb;28 Summary: Although Xeloda has been shown in several large Phase III trials to improve the response rate (with equivalent survival time) over intravenous 5-FU/LV, trials have yet to establish improved 5-year survival rate in Stage III (ongoing)
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11273590&dopt=Abstract |
altman23
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Advances in Treatment Options for Metastatic Colorectal Cancer
Healthtalk November 19, 2002. Dr. Alan Venook, Director of clinical research and professor of clinical medicine at the University of California San Francisco Comprehensive Cancer Center and is Chief of UCSF's gastrointestinal oncology section, and Dr. Edward Lin, Assistant Professor, GI Medical Oncology at The University of Texas M. D. Anderson Cancer Center. Discussion of new CC therapies, including Xeloda. Case history of patinet with 14cm liver tumors "downstaged" by Xeloda/Celebrex
http://www.healthtalk.com/coloncancer/111902/01.html |
altman23
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Capecitabine (Xeloda) improves medical resource use compared with 5-fluorouracil plus leucovorin
PMID: 11290435 Eur J Cancer 2001 Mar;37(5):597-604 Capecitabine treatment in comparison to 5-FU/LV in advanced colorectal carcinoma resulted in superior response rates (26.6% versus 17.9%, P=0.013) and improved safety including less stomatitis and myelosuppression. Capecitabine patients required substantially fewer hospital visits for drug administration than 5-FU/LV patients. Medical resource use analysis showed that patients treated with capecitabine spent fewer days in hospital for the management of treatment related adverse events than did patients treated with 5-FU/LV. In addition, capecitabine reduced the requirement for expensive drugs, in particular antimicrobials fluconazole and 5-HT3-antagonists to manage adverse events.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11290435&dopt=Abstract |
altman23
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Capecitabine as first-line treatment in colorectal cancer. Pooled data from two large, phase III trials
PMID: 11841931 Eur J Cancer 2002 Feb;38 Suppl 2:15-20 Analysis of all (1200)randomised patients demonstrated a significantly superior overall response rate as assessed by the investigator for capecitabine compared with 5-FU/leucovorin (25.7% versus 16.7%, P<0.0002), reinforcing the individual trial results. Median time to disease progression, overall survival and duration of response were equivalent in the two treatment groups. Furthermore, capecitabine showed a superior safety profile compared with 5-FU/leucovorin, with a significantly lower incidence (P<0.001) of diarrhoea, stomatitis, nausea and alopecia, together with a reduced treatment-related hospitalisation rate. In addition, the incidence of neutropenic fever/sepsis was significantly lower in patients receiving capecitabine.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11841931&dopt=Abstract |
altman23
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Capecitabine: a review of its use in the treatment of advanced or metastatic colorectal cancer
PMID: 11772141 Drugs 2001;61(15):2309-26 (Review Article) In patients with advanced or metastatic colorectal cancer, first-line therapy with intermittent capecitabine achieved significantly higher objective tumour response rates than therapy with fluorouracil plus leucovorin in pooled analysis. Response rates were also higher in patients pretreated in the adjuvant setting and whose primary site of metastasis was the lung. However, no significant differences between the two treatment groups were seen in the time to disease progression, time to treatment failure or overall survival
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11772141&dopt=Abstract |
altman23
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Celecoxib attenuated capecitabine induced hand-and-foot syndrome (HFS)
and diarrhea and improved time to tumor progression in metastatic colorectal cancer (MCRC). ASCO 2002 Abstract 2364.(NOTE: "Celecoxib" is Celebrex, an arthritis medication). 67 mCRC patients (pts) taking either capecitabine and celecoxib (A) or capecitabine alone (B) in first/second line settings. Rates of Stable Disease SD (62.5% vs 22.8%) and CEA decline (75% vs 22.8%) occurred in A & B respectively. 2/7 PRs in pts with prior irinotecan occurred only in A. Median time to tumor progression (mTTP) in A & B was 6 vs 3 months respectively and TTP of 10+ months was not reached for 6 Pts in A. HFS, diarrhea and pain were noticeably reduced in A. Interestingly, three pts experienced worsening HFS and diarrhea upon discontinuation of celecoxib.
http://www.asco.org/asco/ascoMainConstructor/1,1003,_12-002324-00_29-00A-00_18-002002-00_19-002364,00.asp |
altman23
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Comparison of oral capecitabine versus intravenous 5-FU/LV as first-line treatment in 605 patients
PMID: 11304782 J Clin Oncol 2001 Apr 15;19(8):2282-92 We prospectively randomized 605 patients to treatment with oral capecitabine for 14 days every 3 weeks or 5-FU/LV by rapid IV injection daily for 5 days in 4-week cycles. RESULTS: The overall objective tumor response rate among all randomized patients was significantly higher in the capecitabine group (24.8%) than in the 5-FU/LV group (15.5%; P =.005). In the capecitabine and 5-FU/LV groups, median times to disease progression were 4.3 and 4.7 months (log-rank P =.72), median times to treatment failure were 4.1 and 3.1 months (P =.19), and median overall survival times were 12.5 and 13.3 months (P =.974)
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11304782&dopt=Abstract |
altman23
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First-line oral capecitabine therapy in metastatic colorectal cancer: a favorable safety profile compared with IV 5-FU/LV
PMID: 12056707 Ann Oncol 2002 Apr;13(4):566-75 1207 patients were randomized to either oral capecitabine (1250 mg/m2 twice daily, on days 1-14 every 21 days) or intravenous (i.v.) bolus 5-FU/leucovorin (Mayo Clinic regimen). CONCLUSIONS: Capecitabine is at least as effective, better tolerated and more convenient than i.v. 5-FU/leucovorin as treatment for patients with metastatic colorectal cancer.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12056707&dopt=Abstract |
altman23
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Xeloda vs Intravenous 5-FU/LV as First Line Treatment in Stage IV CC
PMID: 11689577 J Clin Oncol 2001 Nov 1;19(21):4097-106. We prospectively randomized 602 patients to treatment with capecitabine 1,250 mg/m(2) administered twice daily days 1 to 14 every 3 weeks, or to the 4-weekly Mayo Clinic regimen (5-FU/LV) until disease progression or unacceptable toxicity. RESULTS: The primary objective, to demonstrate at least equivalent response rates in the two treatment groups, was met. The overall response rate was 18.9% for capecitabine and 15.0% for 5-FU/LV. In the capecitabine and 5-FU/LV groups, respectively, median time to disease progression was 5.2 and 4.7 months (log-rank P =.65); median time to treatment failure was 4.2 and 4.0 months (log-rank P =.89); and median overall survival was 13.2 and 12.1 months (log-rank P =.33). CONCLUSION: Oral capecitabine achieved an at least equivalent efficacy compared with IV 5-FU/LV. Capecitabine demonstrated clinically meaningful safety advantages and the convenience of an oral agent.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11689577&dopt=Abstract |
altman23
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