Colon cancer

Adjuvant therapy

Capecitabine (Xeloda)

• Capecitabine (Xeloda) 1250 mg/m2 PO BID days 1-14

Q21days x 8 cycles

References

1. Twelves C, Wong A, Nowacki MP, Abt M, Burris H 3rd, Carrato A, Cassidy J, Cervantes A, Fagerberg J, Georgoulias V, Husseini F, Jodrell D, Koralewski P, Kröning H, Maroun J, Marschner N, McKendrick J, Pawlicki M, Rosso R, Schüller J, Seitz JF, Stabuc B, Tujakowski J, Van Hazel G, Zaluski J, Scheithauer W. Capecitabine as adjuvant treatment for stage III colon cancer. N Engl J Med. 2005 Jun 30;352(26):2696-704. link to original article (contains protocol) PubMed

modified FOLFOX 6

Regimen

• Fluorouracil (5-FU) 400 mg/m2 IV bolus on day 1, then 1200 mg/m2/day IV continuous infusion over 46-48 hours
• Folinic acid (Leucovorin) 400 mg/m2 IV over 2 hours day 1
• Oxaliplatin (Eloxatin) 85 mg/m2 IV over 2 hours day 1

Q14days x 12 cycles

References

1. Kojima S, Ina K, Futamura Y, Ito Y, Hibi S, Nagaoka M, Yuasa S, Kawai M, Nagao S, Kataoka T. A phase I study of modified FOLFOX 6 therapy for advanced colorectal cancer. Gan To Kagaku Ryoho. 2007 Feb;34(2):203-6.

link to original article (Japanese) PubMed

FLOX

Regimen

• Fluorouracil (5-FU) 500 mg/m2 IV bolus 1 hour after start of leucovorin weekly x 6
• Folinic acid (Leucovorin) 500 mg/m2 IV over 2 hours weekly x 6
• Oxaliplatin (Eloxatin) 85 mg/m2 IV over 2 hours on weeks 1, 3, 5; given prior to 5-FU and leucovorin

Q8weeks x 3 cycles

References

1. Kuebler JP, Wieand HS, O'Connell MJ, Smith RE, Colangelo LH, Yothers G, Petrelli NJ, Findlay MP, Seay TE, Atkins JN, Zapas JL, Goodwin JW, Fehrenbacher L, Ramanathan RK, Conley BA, Flynn PJ, Soori G, Colman LK, Levine EA, Lanier KS, Wolmark N. Oxaliplatin combined with weekly bolus fluorouracil and leucovorin as surgical adjuvant chemotherapy for stage II and III colon cancer: results from NSABP C-07. J Clin Oncol. 2007 Jun 1;25(16):2198-204. Epub 2007 Apr 30. link to original article (contains protocol) PubMed

FULV

Regimen

• Fluorouracil (5-FU) 500 mg/m2 IV bolus 1 hour after start of leucovorin weekly x 6
• Folinic acid (Leucovorin) 500 mg/m2 IV over 2 hours weekly x 6

Q8weeks x 3 cycles

References

1. Kuebler JP, Wieand HS, O'Connell MJ, Smith RE, Colangelo LH, Yothers G, Petrelli NJ, Findlay MP, Seay TE, Atkins JN, Zapas JL, Goodwin JW, Fehrenbacher L, Ramanathan RK, Conley BA, Flynn PJ, Soori G, Colman LK, Levine EA, Lanier KS, Wolmark N. Oxaliplatin combined with weekly bolus fluorouracil and leucovorin as surgical adjuvant chemotherapy for stage II and III colon cancer: results from NSABP C-07. J Clin Oncol. 2007 Jun 1;25(16):2198-204. Epub 2007 Apr 30. link to original article (contains protocol) PubMed

XELOX (CapeOx)

Regimen

• Capecitabine (Xeloda) 1000 mg/m2 PO BID days 1-14
• Oxaliplatin (Eloxatin) 130 mg/m2 IV over 2 hours day 1

Q21days x 8 cycles

References

1. Schmoll HJ, Cartwright T, Tabernero J, Nowacki MP, Figer A, Maroun J, Price T, Lim R, Van Cutsem E, Park YS, McKendrick J, Topham C, Soler-Gonzalez G, de Braud F, Hill M, Sirzén F, Haller DG. Phase III trial of capecitabine plus oxaliplatin as adjuvant therapy for stage III colon cancer: a planned safety analysis in 1,864 patients. J Clin Oncol. 2007 Jan 1;25(1):102-9. link to original article (contains protocol) PubMed
2. Cassidy J, Clarke S, Díaz-Rubio E, Scheithauer W, Figer A, Wong R, Koski S, Lichinitser M, Yang TS, Rivera F, Couture F, Sirzén F, Saltz L. Randomized phase III study of capecitabine plus oxaliplatin compared with fluorouracil/folinic acid plus oxaliplatin as first-line therapy for metastatic colorectal cancer. J Clin Oncol. 2008 Apr 20;26(12):2006-12. link to original article (contains protocol) PubMed