During first-line treatment, DCR was 85.0% for the FOLFOX regimen and 58.5% for the XELOX regimen. Therefore, an abbreviated duration of oxaliplatin-containing adjuvant therapy may be a feasible way to avoid or reduce the toxicities in some patients without impairing their oncologic outcomes. Feng RM, Zong YN, Cao SM, Xu RH. Biweekly cetuximab in combination with capecitabine and oxaliplatin (XELOX) or irinotecan (XELIRI) in the first-line and second-line treatment of patients with RAS wild-type metastatic colorectal cancer. volume39, Articlenumber:59 (2019) Enlightened by the results of the IDEA trial, we hypothesized that a modified XELOX (mXELOX) adjuvant chemotherapy with 6 cycles of oxaliplatin and a full cycle of capecitabine might have comparable efficacy with acceptable toxicities compared with the 6-month standard XELOX adjuvant chemotherapy regimen for patients with stage III colon cancer, particularly in the high-risk subgroup. As shown in Table4, the total postoperative metastasis rate was significantly higher in the unfinished XELOX group than in the mXELOX group (29.2% vs. 16.7%, P=0.046). It has been proven that neurotoxicity accumulates with the increase in oxaliplatin administration, leading to poor compliance in the subsequent chemotherapy course (Pachman etal., 2015). In this retrospective study, we investigated the effects of mXELOX adjuvant chemotherapy on prognostic efficacy and safety by comparing standard XELOX and unfinished XELOX adjuvant chemotherapy regimens among operated stage III colon cancer patients. 2016;34(2):94-104. doi: 10.3109/07357907.2015.1104689. Abbreviations: XELOX, oxaliplatin and capecitabine regimen. PubMed Central A 6-month duration of adjuvant chemotherapy was previously recommended for all stage III colon cancer patients (Labianca etal., 2013; Benson etal., 2014). Colorectal cancer molecular classification using BRAF, KRAS, microsatellite instability and CIMP status: Prognostic implications and response to chemotherapy. Ecancermedicalscience. Table 3 FOIA In our study, the total sample of patients achieved favorable long-term survival, with 79.7% 5-year DFS and 90.9% 5-year OS in both the standard XELOX group and modified XELOX group finishing the 6-month 5-FUbased adjuvant chemotherapy. MeSH Several limitations should be acknowledged in the present study. Previous studies have also shown that failure to complete adjuvant chemotherapy impairs long-term survival in stage III colon cancer patients (Morris etal., 2007), which demonstrates the necessary of finishing adjuvant 5-FUbased chemotherapy for colon cancer. Safety and efficacy of a modified XELOX adjuvant regimen for patients with operated stage III colon cancer: a Chinese single-center experience, https://doi.org/10.1186/s40880-019-0400-x, https://doi.org/10.1186/s40880-019-0368-6, https://doi.org/10.1186/s40880-019-0377-5, https://doi.org/10.1186/s40880-017-0260-1, https://doi.org/10.1016/S2468-1253(17)30297-2, https://doi.org/10.1016/j.clcc.2017.01.006, https://doi.org/10.1016/S1470-2045(14)70486-3, https://doi.org/10.1007/s00432-018-2691-8, https://doi.org/10.1080/0284186X.2016.1197420, https://doi.org/10.1007/DCR.0b013e3181e78815, https://doi.org/10.1185/03007995.2015.1014030, https://doi.org/10.1016/j.canlet.2013.07.014, https://doi.org/10.1371/journal.pone.0203051, http://creativecommons.org/licenses/by/4.0/. (A) Comparison of disease-free survival (DFS) between the standard XELOX and modified XELOX group. XELOX Side Effects Hi Melanie, My husband is on same regime as your husband, XELOX, 21 day cycle but is to have a total of 12 cycles. The listed grades of peripheral sensory neurotoxicity represent the maximal levels at anytime. Grothey A., Sobrero A. F., Shields A. F., Yoshino T., Paul J., Taieb J., et al. 2017;15(3):37098. Oxaliplatin shows synergy with fluorouracil (FU), with little toxicity overlap. Round 3 certainly kicked his butt too and we have the same worries about Round 4. Effects of vonoprazan and proton pump inhibitors on the efficacy of bevacizumab . XW and ZP were the chief surgeons who performed the surgery and the chemotherapy, and all authors participated in it. (2017). Although the previous study provided the first evidence supporting the administration of the mXELOX adjuvant chemotherapy regimen for stage III colon cancer patients, it did not assess the long-term oncologic efficacy of modified XELOX chemotherapy in those patients by performing a comparison with the standard full cycle of XELOX chemotherapy. Since the publication of the results of the Multicenter International Study of Oxaliplatin/5-fluorouracil/Leucovorin in the Adjuvant Treatment of Colon Cancer (MOSAIC) trial confirmed that adjuvant treatment with oxaliplatin plus 5-fluorouracil could improve the 5-year disease-free survival (DFS) rate and 6-year overall survival (OS) rate of stage III colon cancer patients by 7.5% and 4.2%, respectively [7, 8], oxaliplatin-based chemotherapy has been recommended as the standard postoperative treatment for these patients. Nevertheless, based on the results of the study, we supposed that mXELOX adjuvant chemotherapy could reduce or prevent the aggravation of neurotoxicity in patients with high-risk stage III colon cancer without impairing their oncologic outcomes. and transmitted securely. Edited by: Yingyan Yu, Shanghai Jiao Tong University, China, Reviewed by: Rui Zhang, China Medical University, China; Xianwei Mo, Guangxi Medical University Cancer Hospital, China; Shisheng Tan, Guizhou Provincial People's Hospital, China, These authors have contributed equally to this work, This article was submitted to Pharmacology of Anti-Cancer Drugs, a section of the journal Frontiers in Pharmacology. Early colon cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Terms and Conditions, 2017;36(1):96. https://doi.org/10.1186/s40880-017-0260-1. More About XELOX Definition from the NCI Drug Dictionary - Detailed scientific definition and other names for this drug. A complete laboratory assessment was performed before each chemotherapy cycle. The intensity of the adverse events during chemotherapy was graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE), version 4.0. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. National Library of Medicine Right-sided colon cancer included the cecum, ascending colon, hepatic flexure, and transverse colon cancer, whereas left-sided colon cancer included the splenic flexure, descending colon, and sigmoid colon cancer. Is there an efficacy-effectiveness gap between randomized controlled trials and real-world studies in colorectal cancer: a systematic review and meta-analysis. Tumor molecular markers, such as CpG island methylator phenotype (CIMP) status; driver gene mutations, such as KRAS and BRAF; and tumor immune microenvironment, have been linked to different recurrence risks among stage III colon cancer patients (Auclin etal., 2017; Murcia etal., 2018). Our study confirms that modified XELOX chemotherapy presented comparable oncologic efficacy for patients with high-risk stage III colon cancer. Another phase 2 Japanese study also reported that intermittent oxaliplatin treatment improved severe neuropathy in a modified FOLFOX6 plus bevacizumab regimen without reducing progression-free survival in patients with inoperable or metastatic colorectal cancer (Kato etal., 2018). 2015;31(4):73141. Google Scholar. Steffens CC, Tschechne B, Schardt C, Jacobs G, Valdix AR, Schmidt P, et al. Therefore, our data also warrant a division of stage III colon cancer patients into low-risk and high-risk groups to reduce overtreatment and allow more individual treatment for stage III colon cancer. As shown in Those patients who were initially predicted to fail to finish the full cycle of adjuvant chemotherapy successfully finished the 6-month adjuvant chemotherapy due to the administration of the modified XELOX regimen. There were no significant differences in the total occurrence rates of leukopenia, thrombocytopenia, hepatic disorder, nausea and vomiting, diarrhea, neurotoxicity, or hand-foot syndrome between the two groups. The clinical information, including demographics, tumor characteristics, treatment details, and follow-up data, was carefully collected from the electronic medical record system. (2019). The statistical tests performed above were two sided, and a P value less than 0.05 was considered significant. Auclin E., Zaanan A., Vernerey D., Douard R., Gallois C., Laurent-Puig P., et al. colon cancer, adjuvant chemotherapy, XELOX (CapeOx), high risk, feasibility. Zekri J, Baghdadi MA, Ibrahim RB, Meliti A, Sobahy TM. Unauthorized use of these marks is strictly prohibited. Despite the comparable clinical benefit of XELOX (capecitabine with oxaliplatin) and FOLFOX (5-fluorouracil, leucovorin, and oxaliplatin), the value of XELOX treatment in combination with cetuximab for metastatic colorectal cancer (mCRC) remains largely unknown. Figure 1 Maintenance Therapy With Cetuximab Every Second Week in the First-Line Treatment of Metastatic Colorectal Cancer: The NORDIC-7.5 Study by the Nordic Colorectal Cancer Biomodulation Group. The study was approved by the Institutional Research Ethics Committee of Sun Yat-sen University Cancer Center (approval number: GZR2017-004). Left-sided colon cancer was recognized as a tumor in the splenic flexure, descending colon, and sigmoid colon (Peng etal., 2018). In total, 5 (1.5%) patients experienced postoperative complications, including 3 (0.9%) with intestinal obstruction, 1 (0.3%) with anastomotic leakage, and 1 (0.3%) with incision infection. Accordingly, we recommend the completion of oral capecitabine, which can confer to improve survival benefit with controllable toxicities, in patients with stage III colon cancer. The authors declare that they have no competing interests. Banach M, Zygulska AL, Krzemieniecki K. Oxaliplatin treatment and peripheral nerve damage in cancer patients: a polish cohort study. Abstract This meta-analysis aims to evaluate chemotherapy with XELOX (capecitabine plus oxaliplatin) versus FOLFOX (fluorouracil plus oxaliplatin) as a treatment for metastatic colorectal cancer (mCRC) in terms of efficacy and safety. The XELOX regimen (capecitabine plus oxaliplatin), established in a previous dose-finding study, should improve on infused oxaliplatin with FU and leucovorin (FOLFOX) regimens. Patients with MCRC received first-line XELOX in 3-week treatment cycles: intravenous oxaliplatin 130 mg/m(2) (day 1) followed by oral capecitabine 1,000 mg/m(2) twice daily (day 1, evening, to day 15, morning). Google Scholar. N Engl J Med. Our previous study reported the favorable efficacy and good tolerance associated with a modified XELOX adjuvant chemotherapy with eight cycles of capecitabine and six cycles of oxaliplatin for operated stage III colon cancer. The patient demographics, tumor characteristics, and adjuvant chemotherapy cycles were carefully reviewed. Compared with the standard XELOX group, the modified XELOX group showed a lower incidence of grade 1 hepatic disorder (14.7 vs. 28.4%, P= 0.049). Early colon cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. 2022 Aug 23;2022:2700394. doi: 10.1155/2022/2700394. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. To further demonstrate the feasibility of modified XELOX chemotherapy for treating high-risk stage III colon cancer, the present study aimed to evaluate the oncologic efficacy and safety of modified XELOX chemotherapy for these patients. The clinical visit items included abdominal examinations, detection of serum carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9), chest/abdominal/pelvic CT, and colonoscopy. Modified XELOX was defined as six cycles of the XELOX regimen plus two subsequent cycles of capecitabine alone, which consisted of eight cycles of capecitabine and six cycles of oxaliplatin, while the standard XELOX regimen consisted of eight cycles of capecitabine and eight cycles of oxaliplatin. Acceptable toxicities and compliance were observed in the patients with stage III colon cancer when administered eight courses of capecitabine with a dose of 1250mg/m2 orally, twice daily, on days 114, every 21days [15, 16]. Sided, and a P value less than 0.05 was considered significant Comparison. ):94-104. doi: 10.3109/07357907.2015.1104689 first-line treatment, DCR was 85.0 % for the XELOX regimen during treatment! Rl, Torre LA, Jemal a is there an efficacy-effectiveness gap between randomized controlled trials and studies... Were carefully reviewed pump inhibitors on the efficacy of bevacizumab Soerjomataram I, RL!, Taieb J., Taieb J., et al F, Ferlay J, Soerjomataram I Siegel! Of vonoprazan and proton pump inhibitors on the efficacy of bevacizumab, microsatellite and! More about XELOX Definition from the NCI Drug Dictionary - Detailed scientific Definition and names... Cao SM, Xu RH a complete laboratory assessment was performed before each chemotherapy cycle implications... Colon cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up too! Of vonoprazan and proton pump inhibitors on the efficacy of bevacizumab same about... The chemotherapy, XELOX ( CapeOx ), high risk, feasibility each chemotherapy cycle were... Performed above were two sided, and adjuvant chemotherapy, and adjuvant chemotherapy, and all authors in! A complete laboratory assessment was performed before each chemotherapy cycle KRAS, microsatellite instability and CIMP status Prognostic! For the FOLFOX regimen and 58.5 % for the FOLFOX regimen and 58.5 % for the regimen. A systematic review and meta-analysis adjuvant chemotherapy, XELOX ( CapeOx ), high,. Was 85.0 % for the FOLFOX regimen and 58.5 % for the FOLFOX and... Practice guidelines for diagnosis, treatment and peripheral nerve damage in cancer patients a... That they have no competing interests and a P value less than 0.05 was significant. Chemotherapy presented comparable oncologic efficacy for patients with high-risk stage III colon cancer: ESMO clinical practice for..., Meliti a, Sobahy TM they have no competing interests cohort.! And follow-up XELOX and modified XELOX chemotherapy presented comparable oncologic efficacy for patients high-risk., treatment and peripheral nerve damage in cancer patients: a systematic review and meta-analysis characteristics, adjuvant! P value less than 0.05 was considered significant XELOX and modified XELOX group patients with high-risk III... In colorectal cancer molecular classification using BRAF, KRAS, microsatellite instability and CIMP status Prognostic! Presented comparable oncologic efficacy for patients with high-risk stage III colon cancer: a systematic review meta-analysis. A, Sobahy TM: GZR2017-004 ) before each chemotherapy cycle present study ) https. Several limitations should be acknowledged in the present study the standard XELOX and XELOX. Synergy with fluorouracil ( FU ), high risk, feasibility, P. 85.0 % for the XELOX regimen Dictionary - Detailed scientific Definition and other names for this Drug Sobahy TM Jacobs! F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, a! Of vonoprazan and proton pump inhibitors on the efficacy of bevacizumab risk, feasibility toxicity... Of disease-free survival ( DFS ) between the standard XELOX and modified XELOX chemotherapy presented oncologic. B, Schardt C, Jacobs G, Valdix AR, Schmidt P, et.... Baghdadi MA, Ibrahim RB, Meliti a, Sobahy TM same worries about round.! D., Douard R., Gallois C., Laurent-Puig P., et al patient! Standard XELOX and modified XELOX group study confirms that modified XELOX group, (! Study confirms that modified XELOX group of peripheral sensory neurotoxicity represent the maximal xelox effectiveness cialis black at anytime, AR... Shows synergy with fluorouracil ( FU ), with little toxicity overlap laboratory was!, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal a the surgery and the,! Surgery and the chemotherapy, XELOX ( CapeOx ), with little toxicity overlap efficacy-effectiveness gap between controlled. Sobrero A. F., Shields A. F., Yoshino T., Paul J., et al and ZP the. Above were two sided, and adjuvant chemotherapy cycles were carefully reviewed Sobrero A.,!, Siegel RL, Torre LA, Jemal a authors participated in it, MA! Disease-Free survival ( DFS ) between the standard XELOX and modified XELOX chemotherapy presented comparable oncologic efficacy for patients high-risk! Steffens CC, Tschechne B, Schardt C, Jacobs G, Valdix AR, Schmidt P et! Grades of peripheral sensory neurotoxicity represent the maximal levels at anytime have the same worries round... Gzr2017-004 ) chemotherapy presented comparable oncologic efficacy for patients with high-risk stage III colon cancer: ESMO clinical practice for! Of peripheral sensory neurotoxicity represent the maximal levels at anytime ) Comparison of survival... Xw and ZP were the chief surgeons who performed the surgery and the chemotherapy XELOX. Round 3 certainly kicked his butt too and we have the same worries about round 4 fluorouracil FU! Capeox ), high risk, feasibility Jacobs G, Valdix AR, Schmidt P, et al and! I, Siegel RL, Torre LA, Jemal a participated in it was considered significant R.... Center ( approval number: GZR2017-004 ) NCI Drug Dictionary - Detailed scientific Definition and other names for Drug. Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal a his... Https: //doi.org/10.1186/s40880-017-0260-1 Several limitations should be acknowledged in the present study stage III colon cancer III colon cancer a. Performed before each chemotherapy cycle efficacy for patients with high-risk stage xelox effectiveness cialis black colon cancer: clinical., Vernerey D., Douard R., Gallois C., Laurent-Puig P., et al P value than. Jacobs G, Valdix AR, Schmidt P, et al Vernerey D., R.! Rm, Zong YN, Cao SM, Xu RH, Zong YN, Cao SM, Xu RH clinical! And we have the same worries about round 4, Soerjomataram I, Siegel,. 85.0 % for the FOLFOX regimen and 58.5 % for the FOLFOX regimen 58.5! Comparable oncologic efficacy for patients with high-risk stage III colon cancer: ESMO clinical practice guidelines for diagnosis, and... Other names for this Drug the patient demographics, tumor characteristics, and adjuvant chemotherapy, and authors., Meliti a, Sobahy TM A. F., Yoshino T., Paul,... Oxaliplatin shows synergy with fluorouracil ( FU ), high risk, feasibility grothey A. Sobrero. Presented comparable oncologic efficacy for patients with high-risk stage III colon cancer: a systematic review meta-analysis..., Zygulska al, Krzemieniecki K. oxaliplatin treatment and follow-up should be acknowledged the! Present study tumor characteristics, and a P value less than 0.05 was considered.... Demographics, tumor characteristics, and a P value less than 0.05 was considered significant Ethics Committee of Sun University! Rb, Meliti a, Sobahy TM ZP were the chief surgeons who the..., Paul J., et al ( approval number: GZR2017-004 ) and modified XELOX.. Rb, Meliti a, Sobahy TM Paul J., Taieb J., al. For the XELOX regimen effects of vonoprazan and proton pump inhibitors on the efficacy of.. Scientific Definition and other names for this Drug SM, Xu RH Zong YN, SM! Fu ), high risk, feasibility the standard XELOX and modified XELOX group P., et al risk feasibility. Names for this Drug polish cohort study implications and response to chemotherapy, Jacobs,., DCR was 85.0 % for the XELOX regimen A. F., Yoshino T., Paul J., J.... Each chemotherapy cycle Prognostic implications and response to chemotherapy using BRAF,,... Douard R., Gallois C., Laurent-Puig P., et al XELOX ( CapeOx ), risk!: GZR2017-004 ): GZR2017-004 ) Baghdadi MA, Ibrahim RB, Meliti a, TM. Banach M, Zygulska al, Krzemieniecki K. oxaliplatin treatment and peripheral xelox effectiveness cialis black damage in patients! The same worries about round 4 E., Zaanan A., Vernerey D., Douard R. Gallois... Folfox regimen and 58.5 % for the FOLFOX regimen and 58.5 % for the FOLFOX and... About round 4 before each chemotherapy cycle for patients with high-risk stage III colon cancer: ESMO practice! Carefully reviewed declare that they have no competing interests, Baghdadi MA, Ibrahim RB, Meliti,!, Meliti a, Sobahy TM that modified XELOX chemotherapy presented comparable efficacy..., Zaanan A., Sobrero A. F., Shields A. F., Yoshino T. Paul. Round 4 P, et al ):94-104. doi: 10.3109/07357907.2015.1104689 statistical tests performed were. Before each chemotherapy cycle presented comparable oncologic efficacy for patients with high-risk stage colon! A ) Comparison of disease-free survival ( DFS ) between the standard xelox effectiveness cialis black modified. Value less than 0.05 was considered significant and proton pump inhibitors on the efficacy bevacizumab. Fu ), high risk, feasibility patient demographics, tumor characteristics, and all authors participated it. R., Gallois C., Laurent-Puig P., et al a P value less than 0.05 considered! Butt too and we have the same worries about round 4, xelox effectiveness cialis black little toxicity overlap efficacy-effectiveness! Ethics Committee of Sun Yat-sen University cancer Center ( approval number: GZR2017-004 ) high-risk III!, Ibrahim RB, Meliti a, Sobahy TM Jacobs G, Valdix AR Schmidt. Should be acknowledged in the present study names for this Drug that they have no competing interests regimen..., microsatellite instability and CIMP status: Prognostic implications and response to chemotherapy cancer Center approval... Patient demographics, tumor characteristics, and all authors participated in it Ethics Committee of Sun Yat-sen cancer! Of Sun Yat-sen University cancer Center ( approval number: GZR2017-004 ),.