Combination therapies with oxaliplatin and oral capecitabine or intravenous 5-FU show similar toxicity profiles in gastrointestinal carcinoma patients if hand-food syndrome prophylaxis is performed continuously

Wehler,Thomas  C.; Cao,Yang; Galle,Peter  R.; Theobald,Matthias; Moehler,Markus; Schimanski,Carl  C.

doi:10.3892/ol.2012.640

June 2012 Volume 3 Issue 6

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June 2012 Volume 3 Issue 6

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Article

Combination therapies with oxaliplatin and oral capecitabine or intravenous 5-FU show similar toxicity profiles in gastrointestinal carcinoma patients if hand-food syndrome prophylaxis is performed continuously

Authors:
- Thomas C. Wehler
- Yang Cao
- Peter R. Galle
- Matthias Theobald
- Markus Moehler
- Carl C. Schimanski
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Affiliations: University Hospital Mainz, III. Medical Department, 55131 Mainz, Germany, University Hospital Mainz, I. Medical Department, 55131 Mainz, Germany
Pages: 1191-1194
|
Published online on: March 9, 2012

https://doi.org/10.3892/ol.2012.640
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Abstract

The use of anticancer drugs in palliative settings is often limited by their severe toxic effects. In gastrointestinal carcinomas the 5-fluorouracil-based palliative regimen FOLFOX-4 is often preferred to the equally effective, but more convenient oral capecitabine-based regimen XELOX. This preference is mainly based on the fact that the highly effective oral agent capecitabine induces hand-foot syndrome (HFS). In this study, we investigated whether the continuous administration of skin prophylaxis (10% urea, panthenol, bisabolol, vitamin A, C and E) is capable of protecting against capecitabine-induced HFS and allowing a more convenient oral therapeutic option. In this retrospective analysis, the toxicity profiles, according to NCI CTCAE 3.0 criteria, of 54 patients with gastrointestinal cancer who received either XELOX (34 patients) or FOLFOX-4 (20 patients) were compared using Fisher tests. The treatment protocols that were compared, herein, did not differ significantly in the majority of the analyzed items, with the exception of increased nausea (XELOX-70), fatigue (XELOX-130) and tumor pain (XELOX-70 and XELOX-130). No significant differences were observed among the various groups with regard to emesis, diarrhea, mucositis, exanthema, alopecia, loss of weight and the incidence of infections. In particular, no significant differences in toxicity levels occurred in terms of dose, and HFS was limited if skin prophylaxis was performed continuously. XELOX-based palliative regimens provide an equally effective and comparably toxic therapeutic alternative to FOLFOX-4 if HFS prophylaxis is performed continuously. Since the oral administration of capecitabine is a more convenient method of application, it provides patients with a quality of life-preserving therapeutic alternative.

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1	Saif MW: Capecitabine and hand-foot syndrome. Expert Opin Drug Saf. 10:159–169. 2011. View Article : Google Scholar : PubMed/NCBI
2	Glimelius B, Hoffman K, Graf W, Påhlman L and Sjödén PO: Quality of life during chemotherapy in patients with symptomatic advanced colorectal cancer. Cancer. 73:556–562. 1994. View Article : Google Scholar : PubMed/NCBI
3	Tournigand C, Andre T, Achille E, et al: FOLFIRI followed by FOLFOX6 or the reverse sequence in advanced colorectal cancer: a randomized GERCOR study. J Clin Oncol. 22:229–237. 2004. View Article : Google Scholar : PubMed/NCBI
4	Van Cutsem E, Hoff PM, Harper P, et al: Oral capecitabine vs intravenous 5-fluorouracil and leucovorin: integrated efficacy data and novel analyses from two large, randomized, phase III trials. Br J Cancer. 90:1190–1197. 2004.PubMed/NCBI
5	Cao Y, Liao Y, Tan A, Liu L, Mo Z and Gao F: Capecitabine plus oxaliplatin vs fluorouracil plus oxaliplatin as first line treatment for metastatic colorectal cancer – meta-analysis of six randomized trials. Colorectal Disease. 12:16–23. 2010.
6	Ducreux M, Bennouna J, Hebbar M, Ychou M, Lledo G, Conroy T, Adenis A, Faroux R, Rebischung C, Bergougnoux L, Kockler L and Douillard J: For the GI Group of the French Anti-Cancer Centers (FNCLCC): Capecitabine plus oxaliplatin (XELOX) versus 5-fluorouracil/leucovorin plus oxaliplatin (FOLFOX-6) as first-line treatment for metastatic colorectal cancer. Int J Cancer. 128:682–690. 2010. View Article : Google Scholar
7	Cassidy J, Tabernero J, Twelves C, et al: XELOX (capecitabine plus oxaliplatin): active first-line therapy for patients with metastatic colorectal cancer. J Clin Oncol. 22:2084–2091. 2004. View Article : Google Scholar : PubMed/NCBI
8	Cassidy J, Douillard JY, Twelves C, et al: Pharmacoeconomic analysis of adjuvant oral capecitabine vs intravenous 5-FU/LV in Dukes’ C colon cancer: the X-ACT trial. Br J Cancer. 94:1122–1129. 2006.PubMed/NCBI
9	Arkenau HT, Arnold D, Cassidy J, Diaz-Rubio E, Douillard JY, Hochster H, Martoni A, Grothey A, Hinke A, Schmiegel W, Schmoll HJ and Porschen R: Efficacy of oxaliplatin plus capecitabine or infusional fluorouracil/leucovorin in patients with metastatic colorectal cancer: a pooled analysis of randomized trials. J Clin Oncol. 26:5910–5917. 2008. View Article : Google Scholar : PubMed/NCBI
10	Cassidy J, Clarke S, Diaz-Rubio E, et al: Randomized phase III study of capecitabine plus oxaliplatin as first-line therapy for metastatic colorectal cancer. J Clin Oncol. 26:2006–2012. 2008. View Article : Google Scholar : PubMed/NCBI
11	Van Cutsem E, Twelves C, Cassidy J, et al: Oral capecitabine compared with intravenous fluorouracil plus leucovorin in patients with metastatic colorectal cancer: results of a large phase III study. J Clin Oncol. 19:4097–4106. 2001.
12	Rothenberg ML, Cox JV, Butts C, Navarro M, Bang YJ, Goel R, Gollins S, Siu LL, Laguerre S and Cunningham D: Capecitabine plus oxaliplatin (XELOX) versus 5-fluorouracil/folinic acid plus oxaliplatin (FOLFOX-4) as second-line therapy in metastatic colorectal cancer: a randomized phase III noninferiority study. Annals of Oncology. 19:1720–1726. 2008. View Article : Google Scholar : PubMed/NCBI
13	Hoff PM, Ansari R, Batist G, et al: Comparison of oral capecitabine versus intravenous fluorouracil plus leucovorin as first-line treatment in 605 patients with metastatic colorectal cancer: results of a randomized phase III study. J Clin Oncol. 19:2282–2292. 2001.PubMed/NCBI
14	Twelves C, Scheithauer W, McKendrick J, Seitz JF, Van Hazel G, Wong A, Díaz-Rubio E, Gilberg F and Cassidy J: Capecitabine versus 5-fluorouracil/folinic acid as adjuvant therapy for stage III colon cancer: final results from the X-ACT trial with analysis by age and preliminary evidence of a pharmacodynamic marker of efficacy. Ann Oncol. Sep 6–2011.(Epub ahead of print).

Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Combination therapies with oxaliplatin and oral capecitabine or intravenous 5-FU show similar toxicity profiles in gastrointestinal carcinoma patients if hand-food syndrome prophylaxis is performed continuously

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