Capecitabine plus oxaliplatin compared with 5-fluorouracil plus oxaliplatin in metastatic colorectal cancer: Meta-analysis of randomized controlled trials

Zhang, Chengyao; Wang, Jiawu; Zhu, Dunru; Li, Yang; Zhu, Pengfei; Wang, Yaxu; Ji-jian, Wang

doi:10.3892/ol.2012.567

Cited by 6 publications

(2 citation statements)

References 22 publications

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“…AEs were similar between XELOX and FOLFOX regimens, with similar rates of grade 3/4 neurosensory toxicity (17%), whereas hand-foot syndrome and diarrhea were more frequently observed in the XELOX arms [ 7 ]. A similar benefit of XELOX and FOLFOX in terms of curative effect has also been reported in a meta-analysis of seven randomized, controlled trials [ 1 , 8 ]. Use of XELOX or FOLFOX in combination with the antiangiogenesis agent bevacizumab as first-line therapy in mCRC has been studied in the NO16966 trial; approximately 40% of patients in each treatment arm had a single metastatic site in this study.…”

Section: Discussionsupporting

confidence: 68%

Management of a Patient with Metastatic Colorectal Cancer and Liver Metastases

Saif

2014

Case Reports in Oncological Medicine

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Liver metastases are commonly encountered in patients presenting with metastatic colorectal cancer (mCRC); resection is the treatment of choice. A number of systemic treatment options are currently available for such patients, including the use of 5-fluorouracil-based chemotherapies and oxaliplatin (e.g., FOLFOX) in combination with biologic agents that target angiogenesis (e.g., bevacizumab). For patients with progression following first-line treatment, current second-line options include a change in chemotherapy with bevacizumab (for patients who did or did not receive prior bevacizumab) or FOLFIRI in combination with aflibercept, a more recently approved antiangiogenesis therapy. Neurotoxicity is a well-established adverse event of oxaliplatin-based therapy. The current case details an mCRC patient with liver metastases who was treated with a capecitabine and oxaliplatin regimen (XELOX), and experienced two episodes of transient cortical blindness possibly related to oxaliplatin. After disease progression, the patient was switched to a regimen of FOLFIRI and aflibercept and did well on this second-line regimen.

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Section: Discussionsupporting

confidence: 68%

Management of a Patient with Metastatic Colorectal Cancer and Liver Metastases

Saif

2014

Case Reports in Oncological Medicine

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“…The fluoropyrimidine, capecitabine (a pro-drug that is preferentially converted to 5-FU in tumour cells), has been designed for oral administration and to be more specific than 5-FU, thus leading to potential differences in the safety profile [2-5]. …”

Section: Introductionmentioning

confidence: 99%

Evaluating Predictive Pharmacogenetic Signatures of Adverse Events in Colorectal Cancer Patients Treated with Fluoropyrimidines

et al. 2013

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The potential clinical utility of genetic markers associated with response to fluoropyrimidine treatment in colorectal cancer patients remains controversial despite extensive study. Our aim was to test the clinical validity of both novel and previously identified markers of adverse events in a broad clinical setting. We have conducted an observational pharmacogenetic study of early adverse events in a cohort study of 254 colorectal cancer patients treated with 5-fluorouracil or capecitabine. Sixteen variants of nine key folate (pharmacodynamic) and drug metabolising (pharmacokinetic) enzymes have been analysed as individual markers and/or signatures of markers. We found a significant association between TYMP S471L (rs11479) and early dose modifications and/or severe adverse events (adjusted OR = 2.02 [1.03; 4.00], p = 0.042, adjusted OR = 2.70 [1.23; 5.92], p = 0.01 respectively). There was also a significant association between these phenotypes and a signature of DPYD mutations (Adjusted OR = 3.96 [1.17; 13.33], p = 0.03, adjusted OR = 6.76 [1.99; 22.96], p = 0.002 respectively). We did not identify any significant associations between the individual candidate pharmacodynamic markers and toxicity. If a predictive test for early adverse events analysed the TYMP and DPYD variants as a signature, the sensitivity would be 45.5 %, with a positive predictive value of just 33.9 % and thus poor clinical validity. Most studies to date have been under-powered to consider multiple pharmacokinetic and pharmacodynamic variants simultaneously but this and similar individualised data sets could be pooled in meta-analyses to resolve uncertainties about the potential clinical utility of these markers.

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