What is Xeloda (Capecitabine)?
Xeloda is the brand name for the chemotherapy agent capecitabine, an antimetabolite type of anticancer drug. It is a prodrug, meaning it's inactive until converted into its active form, fluorouracil (5-FU), within the body. This conversion happens more effectively in tumor cells due to higher levels of the enzyme thymidine phosphorylase, targeting cancer cells while potentially minimizing harm to healthy ones. The activated fluorouracil disrupts DNA and RNA synthesis, hindering cancer cell growth and division.
The Specific Uses for Xeloda
Xeloda is used to treat several cancer types, alone or with other drugs.
Xeloda for Colorectal Cancer
It is used for Stage III (Dukes' C) colon cancer after surgery to prevent recurrence. For metastatic colorectal cancer, it's a first-line treatment, alone or with other agents. For locally advanced rectal cancer, it's part of pre- or post-surgery chemoradiotherapy.
Xeloda for Breast Cancer
Xeloda treats advanced or metastatic breast cancer. It can be used alone if other chemotherapies haven't worked or combined with docetaxel after prior anthracycline treatment.
Xeloda for Gastric and Other Cancers
Xeloda is also used for advanced or metastatic gastric, esophageal, and GEJ cancers in combination with other chemotherapies. For pancreatic cancer, it may be used after surgery with other drugs to prevent recurrence.
Administration and Treatment Schedules
Xeloda is an oral tablet taken twice daily with water within 30 minutes of a meal. Treatment typically follows a cyclical schedule, such as 2 weeks of treatment followed by a 1-week break. The specific schedule and duration of treatment vary based on the type of cancer being treated, whether it is used alone or in combination with other drugs, and individual patient factors. Adjuvant colon cancer treatment often involves multiple three-week cycles.
Managing Common Side Effects of Xeloda
Xeloda can cause side effects, most commonly diarrhea and hand-foot syndrome (HFS). Other potential effects include nausea, fatigue, abdominal pain, and mouth sores. Severe diarrhea should be reported to a healthcare provider, and staying hydrated is important. HFS, causing redness and pain in the hands and feet, can be managed with cooling and comfortable footwear. Nausea and fatigue can often be managed with medication or lifestyle changes.
Comparison of Xeloda to Other Treatments
Xeloda's oral administration is a key difference from many IV chemotherapies. Treatment choice depends on the specific cancer and patient profile.
| Feature | Xeloda (Capecitabine) | Fluorouracil (5-FU) | Avastin (Bevacizumab) |
|---|---|---|---|
| Administration | Oral tablets | Intravenous (IV) infusion | Intravenous (IV) infusion |
| Mechanism | Prodrug converted to 5-FU, disrupting DNA/RNA synthesis | Antimetabolite, directly disrupting DNA/RNA synthesis | Targeted therapy, inhibits growth of new blood vessels for tumors |
| Treatment Cycles | Typically a cyclical schedule (e.g., 2 weeks on, 1 week off) | Varied regimens, often continuous or cyclical IV infusions | Infused typically every few weeks |
| Common Side Effects | Diarrhea, hand-foot syndrome, nausea | Stomatitis, nausea, myelosuppression, diarrhea | Bleeding, hypertension, proteinuria, gastrointestinal perforation |
| Used For | Breast, colorectal, gastric, esophageal, pancreatic cancers | Colorectal, breast, stomach, and other GI cancers | Colorectal, glioblastoma, kidney cancer, lung cancer, ovarian cancer |
Conclusion
Xeloda (capecitabine) is an effective oral chemotherapy for several cancers, particularly metastatic breast and colorectal cancer. Its prodrug nature allows for targeted activation within tumor cells. While convenient, managing side effects like diarrhea and hand-foot syndrome is crucial. The specific treatment regimen is individualized, and understanding Xeloda's role is key for patients considering this therapy.
For more comprehensive information on cancer drugs like Xeloda, resources such as the National Cancer Institute provide detailed drug information and research.
