# CAPOX (capecitabine, oxaliplatin)

Source: https://onco.cc/drugs/capox/  
OnCo record `capox` (Treatment). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

CAPOX pairs the oral fluoropyrimidine capecitabine with intravenous oxaliplatin as a pill-based alternative to FOLFOX. For low-risk stage III colon cancer three months after surgery works as well as six and halves nerve damage; it is also standard in gastric cancer, with hand-foot syndrome as its price.

## Summary

IDEA collaboration (2018): 3 months of CAPOX is non-inferior to 6 for low-risk stage III (T1-3 N1) colon cancer, halving neuropathy. Standard perioperative and first-line option in gastric cancer (with nivolumab in CheckMate 649; with zolbetuximab in GLOW). Hand-foot syndrome from capecitabine replaces some 5-FU toxicity.

## Fields

- Kind: Treatment
- Status: standard-of-care
- Last checked: 2026-09-07
- Code: XELOX
- Modality: Cytotoxic regimen
- Mechanism: Capecitabine is an oral prodrug of 5-FU activated preferentially in tumour; oxaliplatin crosslinks DNA.
- Dosing: Oral + intravenous; Capecitabine 1,000 mg/m² twice daily days 1-14 + oxaliplatin 130 mg/m² day 1, every 21 days

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/XELOX
- Wikipedia: https://en.wikipedia.org/wiki/XELOX

## Connected records

- drugs: [Capecitabine](https://onco.cc/drugs/capecitabine/), [FOLFOX (5-FU, leucovorin, oxaliplatin)](https://onco.cc/drugs/folfox/)
- cancers: [Adenoma-like adenocarcinoma of the colon and rectum](https://onco.cc/cancers/colorectal-adenoma-like-adenocarcinoma/), [Advanced and metastatic small bowel adenocarcinoma](https://onco.cc/cancers/advanced-small-bowel-adenocarcinoma/), [Ampullary cancer (ampulla of Vater)](https://onco.cc/cancers/ampullary/), [Appendiceal adenocarcinoma (mucinous and non-mucinous, including signet ring cell)](https://onco.cc/cancers/appendiceal-adenocarcinoma/), [Appendiceal cancer and pseudomyxoma peritonei](https://onco.cc/cancers/appendiceal/), [BRAF V600E-mutant colorectal cancer](https://onco.cc/cancers/braf-v600e-colorectal/), [Claudin 18.2-positive gastric cancer](https://onco.cc/cancers/gastric-cldn18-2-positive/), [Colon cancer (adenocarcinoma of the colon)](https://onco.cc/cancers/colon-cancer/), [Colorectal cancer](https://onco.cc/cancers/colorectal/), [Early-onset colorectal cancer (under 50)](https://onco.cc/cancers/early-onset-colorectal/), [Familial adenomatous polyposis-associated colorectal cancer](https://onco.cc/cancers/fap-associated-colorectal-cancer/), [Gastric & gastro-oesophageal junction cancer](https://onco.cc/cancers/gastric/), [Goblet cell adenocarcinoma of the appendix](https://onco.cc/cancers/goblet-cell-adenocarcinoma/), [KRAS G12C-mutant colorectal cancer](https://onco.cc/cancers/kras-g12c-colorectal/), [Localised small bowel adenocarcinoma (stage I to III, resected)](https://onco.cc/cancers/localised-small-bowel-adenocarcinoma/), [Low-grade appendiceal mucinous neoplasm and pseudomyxoma peritonei](https://onco.cc/cancers/low-grade-appendiceal-mucinous-neoplasm/), [Micropapillary adenocarcinoma of the colon and rectum](https://onco.cc/cancers/colorectal-micropapillary-carcinoma/), [Mucinous adenocarcinoma of the colon and rectum](https://onco.cc/cancers/colorectal-mucinous-adenocarcinoma/), [PD-L1-high gastric cancer](https://onco.cc/cancers/gastric-pdl1-high/), [Rectal cancer](https://onco.cc/cancers/rectal-cancer/), [Small intestine cancer (small bowel adenocarcinoma)](https://onco.cc/cancers/small-bowel/)
- technologies: [Cytotoxic chemotherapy](https://onco.cc/technologies/cytotoxic-chemotherapy/), [Platinum agents](https://onco.cc/technologies/platinum/)
- trials: [A Clinical Study of SHR-A1811 Combined With Chemotherapy for Platinum Sensitive Recurrent Ovarian Cancer](https://onco.cc/trials/nct06840002/), [A Clinical Study of SHR-A1811 in Combination With Chemotherapy and Bevacizumab Versus Standard Therapy as First-Line Treatment for Advanced Colorectal](https://onco.cc/trials/nct07676162/), [A Phase 2 Clinical Study of ABSK061 and ABSK043](https://onco.cc/trials/nct06632262/), [A Phase 2 Study of SSGJ-707 in Metastatic Colorectal Cancer Patients](https://onco.cc/trials/nct06493760/), [A Phase Ib/II Clinical Study on AK112 Combined or Not Combined With AK119 in pMMR/MSS Colorectal Cancer](https://onco.cc/trials/nct05846867/), [A Phase II Clinical Study Evaluating SSGJ-706 in Combination Therapy for Advanced Gastrointestinal Cancers](https://onco.cc/trials/nct07233850/), [A Phase II Study of AMT-676 Combination Therapies in Advanced Colorectal Cancer](https://onco.cc/trials/nct07474727/), [A Phase Ⅱ/Ⅲ Clinical Trial of RC148 Plus Chemotherapy as 1L Therapy for Unresectable or Metastatic Colorectal Cancer](https://onco.cc/trials/nct07462143/), [A Phase ll Study of Neoadjuvant Short-course Radiotherapy Followed by Ivonescimab and Chemotherapy in pMMR/MSS Locally Advanced Rectal Cancer](https://onco.cc/trials/nct06919510/), [A Study of AK112 With or Without AK117 in Metastatic Colorectal Cancer](https://onco.cc/trials/nct05382442/), [A Study of Amivantamab Monotherapy and in Addition to Standard-of-Care Chemotherapy in Participants With Advanced or Metastatic Colorectal Cancer](https://onco.cc/trials/nct05379595/), [A Study of Anlotinib Hydrochloride Capsule Combined With Chemotherapy as First-line Treatment in Subjects With RAS/BRAF Wild Metastatic Colorectal Can](https://onco.cc/trials/nct04854668/), [A Study of CDX-1140, a CD40 Agonist, in Combination With Capecitabine and Oxaliplatin (CAPOX) and Keytruda in Subjects With Biliary Tract Carcinoma (BTC)](https://onco.cc/trials/nct05849480/), [A Study of GFH276 Combined With Cetuximab or Chemotherapy in Participants With Solid Tumors and Pancreatic Ductal Adenocarcinoma (PDAC) Harboring RAS Mutation](https://onco.cc/trials/nct07678593/), [A Study of HDM2005 in Combination With Standard of Care in Patients With Diffuse Large B-Cell Lymphoma](https://onco.cc/trials/nct07124936/), [A Study of HDM2017 Combination Therapy in Advanced Colorectal Cancer](https://onco.cc/trials/nct07805551/), [A Study of Subcutaneously Injected Epcoritamab Plus Oral Lenalidomide Tablets Compared to Intravenously (IV) Infused Rituximab Plus IV Infused Gemcita](https://onco.cc/trials/nct06508658/), [A Study to Determine the Effect of CT3001 in Patients With Advanced Solid Tumors](https://onco.cc/trials/nct06598007/), [A Study to Evaluate the Adverse Events, and Efficacy of Intravenous (IV) of Telisotuzumab Adizutecan in Combination With IV Oxaliplatin, Fluorouracil,](https://onco.cc/trials/nct06820463/), [A Study to Evaluate the Safety and Efficacy of Pumitamig in Combination With Chemotherapy Versus Bevacizumab in Combination With Chemotherapy in Parti](https://onco.cc/trials/nct07221357/), [A Study to Evaluate the Safety and Efficacy of Two Dose Levels of ONO-4578 With Opdivo®, in Combination With mFOLFOX6 and Bevacizumab Versus Standard ](https://onco.cc/trials/nct06948448/), [A Trial to Evaluate Safety, Tolerability, Pharmacokinetics and Preliminary Efficacy of TST001 in Advanced or Metastatic Solid Tumors](https://onco.cc/trials/nct04495296/), [Adebelimab Combined With Irinotecan Liposomal Injection, Oxaliplatin, Fluorouracil and Calcium Folinate Are Used in the First-line Treatment of Pancreatic Cance](https://onco.cc/trials/nct06531278/), [Anti-PCSK9 Antibody Tafolecimab and Anti-PD-1 Antibody Sintilimab Combined With Neoadjuvant Chemoradiotherapy for pMMR/ MSS Locally Advanced Rectal Cancer : A P](https://onco.cc/trials/nct07686796/), [ASKB589 in Combination With CAPOX and PD-1 Inhibitors in Patients With Advanced, and Unresectable G/GEJ Cancer.](https://onco.cc/trials/nct05632939/), [BOLD-100 in Combination With FOLFOX for the Treatment of Advanced Solid Tumours](https://onco.cc/trials/nct04421820/), [CAIRO3](https://onco.cc/trials/cairo3/), [Cediranib (AZD2171, RECENTIN™) in Addition to Chemotherapy in Patients With Untreated Metastatic Colorectal Cancer](https://onco.cc/trials/nct00399035/), [CheckMate 649](https://onco.cc/trials/checkmate-649/), [CIRCULATE-Japan (GALAXY / VEGA / ALTAIR)](https://onco.cc/trials/circulate-japan/), [CIRCULATE-US](https://onco.cc/trials/circulate-us/), [COLOPEC](https://onco.cc/trials/colopec/), [CtDNA in Adjuvant Chemotherapy of Stage III Colon Cancer (REVISE Trial)](https://onco.cc/trials/nct06242418/), [DCE-MRI for Neoadjuvant Treatment Assessment in Patients With Borderline Resectable Pancreatic Cancer](https://onco.cc/trials/nct07705919/), [DYNAMIC-III](https://onco.cc/trials/dynamic-iii/), [Efficacy and Safety of MB-CART2019.1 vs. SoC in Lymphoma Patients](https://onco.cc/trials/nct04844866/), [Efficacy and Safety of Retlirafusp Alfa Plus Bevacizumab and Chemotherapy With or Without Short-Course Radiotherapy in Patients With CRCLM](https://onco.cc/trials/nct07728019/), [FOG-001 in Locally Advanced or Metastatic Solid Tumors](https://onco.cc/trials/nct05919264/), [FOxTROT](https://onco.cc/trials/foxtrot/), [Gemcitabine Plus Nab-paclitaxel as Switch Maintenance Versus Continuation of Modified FOLFIRINOX as 1st Line Chemotherapy in Patients With Advanced Pancreatic C](https://onco.cc/trials/nct06897644/), [Givastomig Combined With Nivolumab and Chemotherapy in Adults With CLDN18.2 Positive Metastatic Gastric Cancer (GIVA-2)](https://onco.cc/trials/nct07432295/), [HDAC Inhibitor Combination With Chemoimmunotherapy in the Neoadjuvant Treatment of pMMR Locally Advanced Colon Cancer](https://onco.cc/trials/nct06709885/), [HR070803 in Combination With Oxaliplatin, 5-fluorouracil/LV Versus GX as Adjuvant Therapy for Pancreatic Cancer](https://onco.cc/trials/nct06217042/), [HR070803 in Combination With Oxaliplatin, S-1 Versus NALIRIFOX as Adjuvant Therapy for Pancreatic Cancer](https://onco.cc/trials/nct06383078/), [HSK42360-Na Tablets Combined With Cetuximab With or Without Chemotherapy in BRAF V600-Mutant Metastatic Colorectal Cancer](https://onco.cc/trials/nct07790510/), [IBI343 Combined With Chemotherapy in Advanced Pancreatic Cancer](https://onco.cc/trials/nct07692750/), [IDEA collaboration](https://onco.cc/trials/idea-collaboration/), [Iparomlimab/Tuvonralimab Combined With Bevacizumab and CAPEOX as Conversion Therapy for Colorectal Cancer Liver Metastasis](https://onco.cc/trials/nct07007728/), [Irinotecan Liposome for Resectable Pancreatic Cancer With or Without Addebelizumab](https://onco.cc/trials/nct06172036/), [KORTUC (KRC-01) Plus Radiotherapy for Organ Preservation in Rectal Cancer](https://onco.cc/trials/nct07622017/), [Liposomal Irinotecan + Oxaliplatin + Bevacizumab Versus Liposomal Irinotecan + 5-FU/LV](https://onco.cc/trials/nct06782685/), [Liposomal Irinotecan in Combination With Oxaliplatin and S-1 Versus Gemcitabine Combined With Capecitabine as Postoperative Adjuvant Therapy for Pancreatic Canc](https://onco.cc/trials/nct06571461/), [Liposomal Irinotecan, 5-fluorouracil/Calcium Folinate, Oxaliplatin, and Adebrelimab in Combination With Radiotherapy for Resectable or Borderline Resectable Pan](https://onco.cc/trials/nct07542002/), [Modified Sandwich Therapeutic Regimen for Locally Advanced Rectal Cancer](https://onco.cc/trials/nct05228431/), [MRC COIN](https://onco.cc/trials/coin/), [NALIRI-XELOX+AK104 for First-line Treatment of Advanced PDAC](https://onco.cc/trials/nct06405490/), [NC410 and FOLFIRINOX in Combination With Nivolumab With or Without Ipilimumab in Patients With Untreated Metastatic Pancreatic Cancer](https://onco.cc/trials/nct06941857/), [Neoadjuvant CAPOX With or Without Pucotenlimab Plus Selective Radiotherapy for Locally Advanced Rectal Cancer](https://onco.cc/trials/nct07528209/), [Neoadjuvant FOLFOXIRI and Chemoradiotherapy Versus Neoadjuvant CAPOX/FOLFOX and Chemoradiotherapy Followed by Surgery or a Watch-and-Wait Approach in High Risk](https://onco.cc/trials/nct07472868/), [Neoadjuvant FOLFOXIRI Versus CapeOX Chemotherapy for Local Advanced Rectal Cancer](https://onco.cc/trials/nct05201430/), [Neoadjuvant Fruquintinib Plus Tislelizumab Combined With mCapeOX Versus CapeOX for Mid-high pMMR/MSS Locally Advanced Rectal Cancer](https://onco.cc/trials/nct06443671/), [Neoadjuvant Short-Course Radiotherapy With or Without Chemotherapy and AK112 in Locally Advanced Rectal Cancer](https://onco.cc/trials/nct06718543/), [Neoadjuvant/Adjuvant AK104 in Microsatellite Instability-high or Mismatch Repair-deficient, Resectable Colon Cancer](https://onco.cc/trials/nct07412613/), [New EPOC](https://onco.cc/trials/new-epoc/), [Novel Combinations in Participants With Locally Advanced Unresectable or Metastatic Gastric or Gastroesophageal Junction Adenocarcinoma](https://onco.cc/trials/nct05702229/), [OPRA](https://onco.cc/trials/opra/), [Optimizing Immunotherapy Combined With Neoadjuvant Chemoradiotherapy for Locally Advanced Rectal Cancer](https://onco.cc/trials/nct07040098/), [Organ Preservation Following Enverolimab-based Total Neoadjuvant Therapy for Locally Advanced Very Low Rectal Cancer](https://onco.cc/trials/nct05969847/), [PANORAMIX : Optimizing 1st-line NALIRIFOX and Exploring Microbiota's Role in 2nd Line Pancreatic Cancer Treatment](https://onco.cc/trials/nct07028424/), [Pegcetacoplan in Combination With Modified FOLFIRINOX for the Treatment of Metastatic Pancreatic Ductal Adenocarcinoma](https://onco.cc/trials/nct07214298/), [Perioperative Treatment in High-risk Resectable Pancreatic Cancer With NALIRIFOX](https://onco.cc/trials/nct06210360/), [Phase II RCT of LCRT vs SCRT + CAPOX/PD-1i/COX-2i in MSS Locally Advanced Rectal Cancer](https://onco.cc/trials/nct07154316/), [Phase III Study of Ivonescimab or Bevacizumab Combined With FOLFOX in Patients With Metastatic Colorectal Cancer](https://onco.cc/trials/nct07228832/), [Post-resection/Ablation Chemotherapy in Patients With Metastatic Colorectal Cancer (FIRE-9 - PORT / AIO-KRK-0418)](https://onco.cc/trials/nct05008809/), [Pre-Operative Treatment in REseCTable COlon CanceR](https://onco.cc/trials/nct06899477/), [Preoperative FOLFOX Versus Postoperative Risk-adapted Chemotherapy in Patients With Locally Advanced Rectal Cancer](https://onco.cc/trials/nct04495088/), [Prospectively Randomized Control Clinical Trial of FOLFOXIRI Preoperative Chemotherapy Alone on Rectal Cancer in Local Advance Comparing to Oral Capecitabine Co](https://onco.cc/trials/nct03671252/), [QL1706 Plus XELOX as Neoadjuvant Therapy for MSS/pMMR Clinical Stage III Colon Cancer](https://onco.cc/trials/nct07156682/), [QLS5132 Combination Therapy in Advanced Solid Tumors](https://onco.cc/trials/nct07453394/), [Radiotherapy + Systemic Therapy as Conversion Therapy for pMMR/MSS T4M0 Colon Cancer（Neo-Color）](https://onco.cc/trials/nct06949111/), [Randomized Trial of Plasma ctDNA Methylation-Guided Adjuvant Therapy in T4N0 and Low-Risk Stage III Colorectal Cancer](https://onco.cc/trials/nct07562503/), [SBRT Combined With CAPEOX, Bevacizumab, and PD-1 Inhibitor for the Treatment of RAS-Mutant, MSS-Type, Unresectable Metastatic Colorectal Cancer.](https://onco.cc/trials/nct06835179/), [SCOT](https://onco.cc/trials/scot/), [SCRT Sequential Penpulimab in Combination With CAPEOX in the Neoadjuvant Treatment of MSS Locally Advanced Rectal Cancer](https://onco.cc/trials/nct05576480/), [Second-line Zimberelimab and SIRIOX Chemotherapy for Patient With Previously AG Chemotherapy Treated Pancreatic Cancer](https://onco.cc/trials/nct06166589/), [Serplulimab Combined With CAPOX and Bevacizumab as Neoadjuvant Therapy for Locally Advanced Colorectal Cancer](https://onco.cc/trials/nct07819604/), [SIB-RT Combined With CAPOX and PD-1 for High-Risk Rectal Cancer](https://onco.cc/trials/nct07297030/), [SMAD4 Tailored Neoadjuvant Therapy for the Treatment of Resectable and Borderline Resectable Pancreatic Ductal Adenocarcinoma, SMART-PANC Trial](https://onco.cc/trials/nct07748611/), [Spevatamig (PT886) as Monotherapy or in Combination With Chemo and/or ICI, for the Treatment of Patients With Advanced Gastric, Gastroesophageal Junct](https://onco.cc/trials/nct05482893/), [SPOTLIGHT & GLOW](https://onco.cc/trials/spotlight-glow/), [STELLAR (rectal cancer)](https://onco.cc/trials/stellar-rectal/), [Stereotactic Body Radiation Therapy Followed by NALIRIFOX vs NALIRIFOX for Borderline Resectable Pancreatic Cancer](https://onco.cc/trials/nct06259058/), [Study of Zoldonrasib + Chemo of Investigator's Choice vs Placebo + Chemo of Investigator's Choice as First-line Treatment in Metastatic KRAS G12D-muta](https://onco.cc/trials/nct07621718/), [Study to Assess the Safety, Tolerability, and Efficacy of IDX-1197 in Combination With XELOX or Irinotecan in Patients With Advanced Gastric Cancer](https://onco.cc/trials/nct04725994/), [Study to Evaluate Loncastuximab Tesirine With Rituximab Versus Immunochemotherapy in Participants With Relapsed or Refractory Diffuse Large B-Cell Lym](https://onco.cc/trials/nct04384484/), [Testing Higher Dose Radiation Therapy for Locally Advanced Pancreatic Cancer](https://onco.cc/trials/nct06958328/), [TNT of SCRT+CAPOX vs SCRT+CAPOXIRI for Locally Advanced Rectal Cancer](https://onco.cc/trials/nct05646511/), [TOSCA](https://onco.cc/trials/tosca/), [Tucatinib Plus Trastuzumab and Oxaliplatin-based Chemotherapy or Pembrolizumab-containing Combinations for HER2+ Gastrointestinal Cancers](https://onco.cc/trials/nct04430738/), [Tumor Subtypes in Subjects on FOLFIRINOX With Non-Metastatic Pancreatic Cancer](https://onco.cc/trials/nct03977233/), [Umbrella Trial of Neoadjuvant Therapy for Locally Advanced Colorectal Cancer](https://onco.cc/trials/nct07503639/), [XELOX Plus DoSTARlimab Versus XELOX Alone as Consolidation Treatment After Standard Chemoradiation in pMMR/MSS or MSI-Low Locally Advanced Rectal Cancer (LARC)](https://onco.cc/trials/nct07381777/), [Zolbetuximab With mFOLFOX6 or CAPOX in Claudin 18.2 Overexpressed Advanced or Metastatic Biliary Tract Cancers](https://onco.cc/trials/nct07723534/)
- people: [Matt Seymour](https://onco.cc/people/matt-seymour/), [Rachel Kerr](https://onco.cc/people/rachel-kerr/)
- key papers: [Duration of adjuvant chemotherapy for stage III colon cancer (the IDEA collaboration)](https://onco.cc/key-papers/paper-idea-duration-adjuvant-stage-iii-colon-nejm-2018/), [Localised colon cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up](https://onco.cc/key-papers/paper-esmo-localised-colon-cancer-guideline-ann-oncol-2020/), [Organ preservation in patients with rectal adenocarcinoma treated with total neoadjuvant therapy (OPRA)](https://onco.cc/key-papers/paper-garcia-aguilar-opra-organ-preservation-jco-2022/), [Phase 2 study of capecitabine and oxaliplatin for advanced adenocarcinoma of the small bowel and ampulla of Vater](https://onco.cc/key-papers/paper-overman-capox-small-bowel-adenocarcinoma-jco-2009/), [Preoperative chemotherapy for operable colon cancer: mature results of an international randomized controlled trial (FOxTROT)](https://onco.cc/key-papers/paper-foxtrot-preoperative-chemotherapy-colon-jco-2023/), [Short-course radiotherapy followed by chemotherapy before total mesorectal excision versus preoperative chemoradiotherapy in locally advanced rectal cancer (RAPIDO)](https://onco.cc/key-papers/paper-bahadoer-rapido-short-course-radiotherapy-lancet-oncol-2021/), [The Chicago Consensus on peritoneal surface malignancies: management of appendiceal neoplasms](https://onco.cc/key-papers/paper-chicago-consensus-appendiceal-neoplasms-cancer-2020/)
- roadmaps: [Colorectal cancer roadmap: from the adenoma-carcinoma sequence and the first screening trials to total mesorectal excision, oxaliplatin, RAS testing, immunotherapy for mismatch repair-deficient disease, ctDNA-guided treatment and organ preservation](https://onco.cc/roadmaps/colorectal-roadmap/)
- ideas: [Randomise organ preservation against surgery in mismatch repair-proficient rectal cancer, with bowel function as a co-primary endpoint](https://onco.cc/ideas/idea-crc-organ-preservation-randomised-in-pmmr-rectal/), [Take ctDNA-guided de-escalation beyond stage II, and stop escalating on a positive result until a trial says it helps](https://onco.cc/ideas/idea-crc-ctdna-de-escalation-beyond-stage-ii/)
- terms: [Living with FOLFOX, CAPOX, FOLFIRI and the EGFR antibodies](https://onco.cc/terms/chemotherapy-side-effects-colorectal/)

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