Modified XELIRI
Checked 2026-09-09
Metastatic colorectal cancer, second line, as an alternative to FOLFIRI, with or without bevacizumab
Also called XELIRI, CAPIRI, mXELIRI.
One cycle
every 21 daysComponents
| Drug | Dose | Route | Days | Note |
|---|---|---|---|---|
Irinotecan Topoisomerase I inhibitor (camptothecin prodrug) | 200 mg/m² | IV | D1 | |
Capecitabine Oral fluoropyrimidine prodrug (antimetabolite) | 800 mg/m² twice daily | Oral | D1-14 |
Cycles
until progression
21-day cycle
Emetogenicity
Moderate (30-90%)
G-CSF
Not routine
Notes
- The original XELIRI doses (irinotecan 250 mg/m², capecitabine 1,000 mg/m² twice daily) caused excess diarrhoea in BICC-C; the modified doses are the ones used now.
- Check for UGT1A1 poor metabolisers before irinotecan.
Used in
Source
Xu (AXEPT), Lancet Oncology 2018: modified XELIRI non-inferior to FOLFIRI
Reference doses for a typical adult from the cited protocol or label. Doses are adjusted for renal and hepatic function, age, performance status and prior toxicity, and institutional protocols vary. Verify against the current label and your local protocol before treating. Not medical advice.
Other regimens for these cancers
mFOLFOX6
Adjuvant stage III colon (6 months) or metastatic colorectal and upper GI first line
every 14 days × 12
CAPOX
Adjuvant stage III colon (3 or 6 months), rectal total neoadjuvant therapy, metastatic first line
every 21 days × 4
FOLFIRI
Metastatic colorectal first or second line (with bevacizumab, aflibercept, ramucirumab or an anti-EGFR antibody)
every 14 days
Trifluridine/tipiracil + bevacizumab
Refractory metastatic colorectal cancer after two lines
every 28 days
Pembrolizumab monotherapy
Adjuvant melanoma stage IIB-IV (1 year); PD-L1 TPS 50% or above NSCLC; MSI-high tumours; recurrent head and neck (CPS 1 or above)
every 21 days
Fluorouracil and leucovorin (LV5FU2)
Colorectal cancer when oxaliplatin or irinotecan cannot be given; the fluoropyrimidine backbone of FOLFOX and FOLFIRI
every 14 days × 12