Capecitabine
Capecitabine (Xeloda) is a tablet form of the chemotherapy fluorouracil. It is a backbone of treatment for bowel cancer and a standard option in advanced breast cancer.
Overview
Capecitabine was approved by the FDA in 1998 for anthracycline- and taxane-resistant metastatic breast cancer and later for adjuvant stage III colon cancer (X-ACT: disease-free survival at least equivalent to bolus fluorouracil and leucovorin), metastatic colorectal cancer, perioperative chemoradiotherapy for rectal cancer and, with docetaxel, for anthracycline-pretreated breast cancer. The EU authorised Xeloda in 2001; it is also approved there for gastric cancer. It is the oral partner in CAPOX and CAPTEM and in the CREATE-X post-neoadjuvant breast regimen. Hand-foot syndrome, diarrhoea and cardiotoxicity are the key toxicities, and DPD deficiency (DPYD variants) causes severe or fatal toxicity, so genotype-guided dosing is increasingly used. Warfarin interaction carries a boxed warning.
- AmivantamabApproved
- CamizestrantApproved
- Comprehensive genomic profilingStandard of care
- Liquid biopsy (ctDNA)Standard of care
- LorlatinibApproved
- MRD / molecular residual disease testingEstablished
- ADC payload neutralisersPhase 1
- BGB-16673Phase 3
- Bispecific ADCPhase 3
- BRUIN CLL-321Positive
- CaDAnCe-304Recruiting
- CIRCULATE-Japan (GALAXY / VEGA / ALTAIR)Active
- A clone report from blood at every treatment cycle
- A fast route to the matched drug when it is licensed for another cancer
- A multi-cancer platform trial of adaptive (dose-holiday) therapy
- A national rapid research autopsy network for end-stage cancer
- A standard evolvability score for every tumour
- A standing platform trial that assigns treatment by how the tumour escaped
Background: ADC sequencing, Antigen escape (antigen loss, lineage switch), BCG-unresponsive, Castration-resistant prostate cancer (CRPC), Circulating tumour DNA (ctDNA). Also on OnCo: Resistance atlas: how tumours escape and what closes the route · Lines of therapy.
Approvals
| Region | Year | Indication |
|---|---|---|
| US | 1998 | Metastatic breast cancer after anthracycline and taxane; later adjuvant and metastatic colorectal cancer, rectal chemoradiotherapy |
| EU | 2001 | Colorectal, gastric and breast cancer |
Trials
topRecruiting now (live from ClinicalTrials.gov)
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Latest papers
topQuery for this drug: (TITLE:"Capecitabine" OR ABSTRACT:"Capecitabine" OR TITLE:"Xeloda" OR ABSTRACT:"Xeloda") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Capecitabine, not a curated reading list.
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