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. 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......"
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