Xeloda dosing

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Siti
Posts: 247
Joined: Thu Aug 01, 2019 10:58 am

Re: Xeloda dosing

Postby Siti » Thu Dec 22, 2022 4:56 pm

Hi Rob,

I am really sorry to hear about your bad scan. I think you’re possibly one of the most well informed patient here so I’m not sure if my input would be any good but just sharing based on experience.

The doctors in Netherlands do not recommend high dose of any supplements. They believe that sometimes it can interfere with chemo / could put too much burden on your liver. My husband decided to follow their advice however takes D3, Coriolus versicolor & Curcuma based on the labels’ dose.

My husband switched from Capecitabine to TS-1 due to bad HFS. His HSF was bad even after dose reduction so his oncologist switched to Teysuno (TS-1).

For his feet — he uses Flexitol cream for skin repair (it’s the best, I saw the improvement myself!) and haemorrhoids cream when it’s painful. For neuropathy, acupuncture helps but lasts only a few days so it needs to be done frequently. At the moment he goes once every 2-3 weeks.

So far everything seems to be working well and we hope it will stay that way.

Siti
Wife of DH (54) DX on 5/7/19
Sigmoid | Adenocarcinoma | Grade: G3 | LNs: 30/31
Wild Type for KRAS, NRAS and BRAF
19/7/19 PET-CT Scan: Distant lymph nodes (para-aorta, neck & hip), est. size 0.5-1.5cm.
22/7/19 Surgery: Laparoscopic Colon Resection
26/8/19 Chemo: CAPEOX + Avastin x 7
6/11/19 CT Scan after 3rd cycle, all nodes have shrunk! Yay!! 20/12/19 Last round of Ox (NED)
1/2020 Maintenance: Cap + Avastin
4/2020 Maintenance: switch to Teysuno (S-1) + Avastin due to bad HFS side effects.

zephyr
Posts: 331
Joined: Thu Aug 18, 2016 7:31 am

Re: Xeloda dosing

Postby zephyr » Thu Jan 12, 2023 1:45 pm

I'm late to this party but wanted to add some comments that may be useful. I was on Xeloda/Avastin and stable for almost 18 months with no breaks outside of those prescribed. I had a few hand/foot flares but they were short-lived and I possibly could have largely avoided them by being more careful about not walking barefoot so much and not taking hot, hot showers. Like you and others, I avoided foods supplemented with folic acid, which was challenging because the practice is so prevalent in North America. I personally didn't worry about naturally occurring folates. I did IV-C every week. All those things helped but I think the most helpful difference was my dosing schedule: 5 days on and 2 days off, 52 weeks a year, with no other breaks outside of the weekends. There was a post here a few years ago about how Xeloda becomes more toxic at about day 8 but without any added efficacy so I was happy for the 5/2 schedule that didn't take me out to Day 8. The bolus was also removed from my protocol. I'm not a doctor or anything medical so I can't give offer that expertise or more technical information, just offering my experience as something you may want to consider asking your oncologist to consider if you're having regular side effects and having to take breaks.
Nov-2009 Early stage CRC, routine colonoscopy
2010-2014 F/U colonoscopies, all clear
Jun-2016 CRC during F/U colonoscopy, surgery, Stage 4, KRAS, MSS, inop lung mets
Aug-2016-May-2018 Folfox, 5FU & Avastin, 5FU, Folfiri & Cyramza
Aug/Sep-2018 YAG laser surgeries (Germany), 11 nodules removed
Nov-2018 clean CT scan
Mar-2019 New lung nodules
Apr-2019 Dec-2020 Xeloda/Avastin, SBRT, cont. Xeloda/Avastin
Dec-2020 Progression
Mar-2021 Forfiri/Avastin
Mar-2022 Ablation & Thoracotomy

Rock_Robster
Posts: 742
Joined: Thu Oct 25, 2018 5:27 am
Location: Brisbane, Australia

Re: Xeloda dosing

Postby Rock_Robster » Thu Jan 12, 2023 11:02 pm

Thanks Zephyr, that’s really helpful. I just had another temporary dose reduction (down to 3000mg/d for one cycle) and an extra 2 days’ break, so I’ll ask my onc whether a 5/2 schedule might be more sustainable.9
40M Australia
2018 Dx RC 12cm high
G2 EMVI LVI, 4 liver mets
pT3N1aM1a Stage IVa MSS NRAS G13R
CEA: Nov-18: 14 > 2
Jun-22: 5
Sep: 10
Nov: 19
Dec/Jan-23: 17-19
11/18 FOLFOX
3/19 Liver resect
5/19 Pelvic IMRT
7/19 ULAR
8/19 Liver met
8/19 FOLFOX, FOLFOXIRI, FOLFIRI
12/19 Liver resect
NED
11/21 Liver met, PALN, sub-cm lung mets
3-4/22 Lymphadenectomy, liver SBRT
9/22 Liver met, PALN
10/22 PALN SBRT
11/22 Liver mets, nodes, peri nodules. Xeloda+Avastin
1/23 Liver/lungs stable. Lymph/peri undetectable

DCook54
Posts: 31
Joined: Sat Sep 05, 2020 10:12 pm

Re: Xeloda dosing

Postby DCook54 » Sat Jan 14, 2023 11:59 pm

I have been on Xeloda for about 17 months with no evidence of disease following my last VATS. I take 1500 mg twice a day for 7 days on and then 7 days off. I have had no issues with hfs. The main side effect I deal with is being so tired, especially with the chemo week tiredness continues into the off week. I have my next scans in February, and will continue on Xeloda as long as it is keeping me clear. My onc did give me the option of taking a break from it since there is NED but I am afraid to try bc I’ve already had wedge resections on my right lung once and my left lung twice, and I just believe I will have more Mets if I stop. I asked him about adding avastin, but he felt that it wasn’t needed because I am NED.

I agree about Flexitol for feet! I have extremely dry skin,and it really does work.
54 yo f
Stage IV colon- mets to lungs
KRAS G12V
Dec 2019- partial colect adenocarcinoma
0/31 LN
Jan 2020-PET NED
Jan 2020- Staged at I
July 2020-Ct-nodules both lungs
July 2020-VATS both lungs pos crc mets Stage IV
Aug 2020 began 1/6 cycles Folfox
Nov 20 Comp 6 Folfox
Dec 20 Colonoscopy/CTs clean
Dec 20 NED
April 21 Stable scans. 4 mm lung nodule to watch
Aug 21 VATS 2 nodules cancer
Sept 21-present Xeloda Main.
Nov 22 clear scans = 15 months NED
Dec 22 pleural effusion neg for cancer


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