Xeloda One week on/one week off dosing

Please feel free to read, share your thoughts, your stories and connect with others!
Cj51
Posts: 892
Joined: Thu May 13, 2010 5:58 pm
Location: Midwest

Xeloda One week on/one week off dosing

Postby Cj51 » Wed Jan 05, 2011 11:32 am

In a different thread, I read that some of you are on a one week on/one week off dosing schedule for Xeloda, as opposed to the 14 days on/7 day off schedule. Someone even said that this was "more effective". This sent me on a wild Google chase for more info on this, perhaps studies or something written somewhere but I'm coming up short on that. I'm not sure if I'm using the right search parameters or what, but I'm coming up with more stuff on breast cancer and nothing about this dosing schedule for rectal or colon cancer. Can anyone provide any documentation that this dosing schedule has been shown to work just as well or better than the 14/7 schedule? I'd like to explore this, since about day 8 of Xeloda, my gut goes wild and my hands and feet are starting to peel, etc. After 7 days off, I'm much better. It seems like this dosing schedule might work better for me, but I'd like to show up at my next appt with some information, rather than "hey, Doc, I heard on one of my internet forums that...." :P
He tends to be very open to new ideas, so if this has any proven merit, it'll fly with him. (I have an awesome Onc)

Thanks!
Cj
DX Stage IIIb RC, T3N1M0, April 2010, 51
6 wks Xelox/rad 6/10
resection, temp illeostomy 8/10 Complete response!
12 rounds FOLFOX for clean up 9/10, Allergic to Oxi, started Xeloda only 12/10
Ileo takedown 9/28/11
10/15 NED

User avatar
Terry
Posts: 5536
Joined: Wed Oct 03, 2007 10:36 pm
Facebook Username: Terry Minor
Location: Silver Cliff, Wisconsin

Re: Xeloda One week on/one week off dosing

Postby Terry » Wed Jan 05, 2011 11:42 am

Everything I read talked about it being well tolerated up to 2000mg twice a day and then goes into they'e doing a study to see what the efficacy is with breast cancer. I would tell him you read an article (you don't have to say internet), that they had been trying patients on a one week on and one week off schedule of xeloda and it said it was very well tolerated. You were wondering if that might help with your hand/foot syndrome since it seems to start after day eight and ask what he has heard about the effectiveness. I'm sure he's heard of it because they go to meetings all the time about new things. The article I read was in 2008 and the trial on the effectiveness of it with breast cancer had not begun yet so at this point maybe all the evidence isn't in so he only is doing what is proven to start with unless the patient experiences problems.

Have you tried Eucerin Calming and Moisturizing lotion? I was on Xeloda for almost 2 years and used it twice a day (at least) and it stopped the itching within seconds and really helped them to get better almost immediately.

Your in my prayers!
Terry
DX 7/3/07
Chemo, radiation, 20 mo. chemo, IMRT, cyberknife, 6/11 lobectomy.
1/16 resection perm. colostomy intraop. rad.
PET 2/12 nose, thyroid, liver, lngs
Folfox 3/12
Lord I know You'll keep me here until
you know I cannot suffer any longer!

Cj51
Posts: 892
Joined: Thu May 13, 2010 5:58 pm
Location: Midwest

Re: Xeloda One week on/one week off dosing

Postby Cj51 » Wed Jan 05, 2011 12:00 pm

Thanks, Terry! It sounds like we read the same article regarding the dosing schedule tried for breast cancer.
I do have a tube of the Eucerin lotion you mentioned--I got it when I was on the Xeloda/Radiation based on your recommendation! :-) It helped then, I never had any trouble at all with hand/foot. However, I'm on a higher dose now, and it doesn't seem to be keeping up. So, I started using it on my hands during the day to try and keep ahead of the redness and itching, and have switched to what I call "library paste", the original Eucerin paste on both hands and feet at night. I slather it on thickly and cover my feet with cotton socks, then do a thick coating on my hands. By morning, things seem to be much better. However, by day 9 or 10 I'm still pretty sore. I'm going to bring this up with my Oncologist/PA next appointment. If I'm having trouble getting through all 14 days, this might be my solution. This last time, I stopped at day 10, took a break, and am finishing up the last 4 days this week. This would be similar, just doing it on a planned schedule.

Cj
DX Stage IIIb RC, T3N1M0, April 2010, 51
6 wks Xelox/rad 6/10
resection, temp illeostomy 8/10 Complete response!
12 rounds FOLFOX for clean up 9/10, Allergic to Oxi, started Xeloda only 12/10
Ileo takedown 9/28/11
10/15 NED

Surroundedbylove
Posts: 3118
Joined: Tue Dec 16, 2008 6:43 am
Location: Seattle

Re: Xeloda One week on/one week off dosing

Postby Surroundedbylove » Wed Jan 05, 2011 12:01 pm

The original article mentioned in the other thread was a posting on Medscape by Dr. Marshall from Georgetown in Washington, DC.

Here is a link to the other thread with a copy of the article pasted into the original posting but unfortunately the original poster took down the link to the Medscape article.

The Medscape posting by Dr. Marshall includes his reasoning and a reference to an old study:

".....What we have to do is go back to a very important paper by our colleague, Eric van Cutsem, published in the Journal of Clinical Oncology, in the year 2000, before capecitabine was even approved by the FDA.[1] They did a colon cancer study that looked at 3 different dose schedules for capecitabine. The first was the 2-weeks-on, 1-week-off schedule that we all hate, at a dose of 2510 mg/m2/day in 2 divided doses. The second arm was a dose-reduced version, 1657 mg/m2/day in 2 divided doses (using both small and big tablets) along with low-dose leucovorin, also given on the 2-weeks-on, 1-week-off schedule. The third arm (which, by the way, is going to be the winner in my heart) was a lower dose, 1331 mg/m2/day, in 2 divided doses, given daily without any breaks -- no week-on/week-off schedule -- just continuously dosed in patients with colon cancer.

The results of this clinical trial showed that each of those 3 doses and schedules were the same in terms of benefit. They had the same response rate, the same number of complete and partial responses -- essentially all right around 20%-25% -- no differences were found.

However, there was a difference in toxicity, with the continuously dosed regimen being less toxic than the intermittent dose and the higher doses, so fewer dose reductions were necessary, and it was better tolerated over the long haul. On the basis of that, it really was the winner of this clinical trial......"


viewtopic.php?f=1&t=17920&p=136336&hilit=georgetown#p136336
Surroundedbylove

Rectal Cancer @ 43, '08
Clinical: T3,N2a,MX (IIIB)
6 wks XELOX & radiation
LAR, colonic j-pouch, & temp ileo '09
Surgical: ypT3,ypN0,ypMX (0 of 20 nodes)
FOLFOX; XELOX
Ileo Takedown '09
SIL Dx 2014 - Rectal T3

Cj51
Posts: 892
Joined: Thu May 13, 2010 5:58 pm
Location: Midwest

Re: Xeloda One week on/one week off dosing

Postby Cj51 » Wed Jan 05, 2011 12:59 pm

Thanks, SBL--at least it's a start.
I find it interesting that the benefit seems the same no matter how you dose it. The difference tends to be the toxicity. I read on the Xeloda site that it also doesn't seem to matter if you pause, restart, or even decrease the does slightly.
Cj
DX Stage IIIb RC, T3N1M0, April 2010, 51
6 wks Xelox/rad 6/10
resection, temp illeostomy 8/10 Complete response!
12 rounds FOLFOX for clean up 9/10, Allergic to Oxi, started Xeloda only 12/10
Ileo takedown 9/28/11
10/15 NED

ams5796
Posts: 2288
Joined: Fri Feb 06, 2009 10:07 am

Re: Xeloda One week on/one week off dosing

Postby ams5796 » Wed Jan 05, 2011 5:22 pm

I am on a one week on/one week off dosing of Xeloda. I have been since June. It was prescribed by Dr Kemeny at Sloan-Kettering, one of the best in the business. I hope that it's effective, it has kept my lung mets stable but has not shrunk them much. I'm going to Sloan on Monday. We'll see what's going on now.

My side effects are not terrible. Mostly I deal with fatigue and bowel issues. :oops:

Good luck.

Ann
Stage 3C (or 4?) Rectal Cancer 01/07
2/10 lung mets
3/11 VATS
6/11 VATS
7/13 lung met
2/14 SBRT
NED 8/14
5/17 scan and MRI found treated spine met

europn1

Re: Xeloda One week on/one week off dosing

Postby europn1 » Tue May 24, 2011 11:15 pm

Dear Ams,

You mentioned you had been taking the Xeloda since last June, how are you feeling now? My Mom just started the 1 wk on / 1 wk off schedule for met lung cancer - and wanted to know how it worked for you. :D

Tek
Posts: 0
Joined: Mon May 30, 2011 10:02 am

Re: Xeloda One week on/one week off dosing

Postby Tek » Mon May 30, 2011 12:29 pm

Just dx stage 4 BC mets in lymphatics, only maintenance chemo on offer, onc suggested xeloda but I want quality of life. Anyone able to encourage me that side effects are minimal or that it does any good at all?

Thanks
Tek

missjv
Posts: 1416
Joined: Tue Sep 12, 2006 10:38 am
Location: FLORIDA

Re: Xeloda One week on/one week off dosing

Postby missjv » Tue May 31, 2011 9:30 am

SOME PEOPLE DO FINE WITH XELODA OTHERS DON'T IT IS HARD TO SAY THAT YOU WILL OR WILL NOT HAVE ANY SIDE EFFECTS. WHEN I STARTED I HAD SOME SIDE EFFECTS AND MY XELODA DOSE WAS TWEAKED I DO STILL HAVE SOME TIREDNESS AND ITCHY HANDS AND FEET AND AS FOR QUALITY OF LIFE IT IS GREAT I DO EVERYTHING I DID BEFORE WHILE OFF CHEMO EXCEPT I GO LIGHT ON THE ALCOHOL. AS FAR AS EFFECTIVNESS YOU WON'T KNOW UNTIL YOU TRY. SOME PEOPLE HAVE GREAT RESULTS WHILE OTHERS DO NOT.


MISSJV

User avatar
WriterGirl1969
Posts: 505
Joined: Sat Mar 05, 2016 3:48 pm
Location: Central NY

Re: Xeloda One week on/one week off dosing

Postby WriterGirl1969 » Thu Apr 11, 2019 10:30 pm

Surroundedbylove wrote:The original article mentioned in the other thread was a posting on Medscape by Dr. Marshall from Georgetown in Washington, DC.

Here is a link to the other thread with a copy of the article pasted into the original posting but unfortunately the original poster took down the link to the Medscape article.

The Medscape posting by Dr. Marshall includes his reasoning and a reference to an old study:

".....What we have to do is go back to a very important paper by our colleague, Eric van Cutsem, published in the Journal of Clinical Oncology, in the year 2000, before capecitabine was even approved by the FDA.[1] They did a colon cancer study that looked at 3 different dose schedules for capecitabine. The first was the 2-weeks-on, 1-week-off schedule that we all hate, at a dose of 2510 mg/m2/day in 2 divided doses. The second arm was a dose-reduced version, 1657 mg/m2/day in 2 divided doses (using both small and big tablets) along with low-dose leucovorin, also given on the 2-weeks-on, 1-week-off schedule. The third arm (which, by the way, is going to be the winner in my heart) was a lower dose, 1331 mg/m2/day, in 2 divided doses, given daily without any breaks -- no week-on/week-off schedule -- just continuously dosed in patients with colon cancer.

The results of this clinical trial showed that each of those 3 doses and schedules were the same in terms of benefit. They had the same response rate, the same number of complete and partial responses -- essentially all right around 20%-25% -- no differences were found.

However, there was a difference in toxicity, with the continuously dosed regimen being less toxic than the intermittent dose and the higher doses, so fewer dose reductions were necessary, and it was better tolerated over the long haul. On the basis of that, it really was the winner of this clinical trial......"


viewtopic.php?f=1&t=17920&p=136336&hilit=georgetown#p136336


Bumping this topic back up since there have been a couple questions regarding Xeloda.
DX 3/4/2016 Colon Cancer; age 46 Mom of then 4-yr-old
Stage IIIB: T3N1M0
3/31/16 Surgery
4 to 10/2016: Xeloda Monotherapy
CEA: 10/16 0.56, 1/17 0.54
CT CLEAR: 3/6/17; 4/17/18; 4/16/19
NED 3 years
“If I can help somebody as I walk along, then my living shall not be in vain.”


Return to “Colon Talk - Colon cancer (colorectal cancer) support forum”



Who is online

Users browsing this forum: No registered users and 36 guests