Efficacy and safety of capecitabine and oxaliplatin (CAPOX) treatment in colorectal cancer: An observational study from a tertiary cancer center in South India

• Published in: Indian journal of cancer Vol. 59; no. 1; pp. 73 - 79
• Main Authors: Kalidindi, Ashok, Dubashi, Biswajit, Jayanthi, M, Shewade, D
• Format: Journal Article
• Language: English
• Published: India Wolters Kluwer India Pvt. Ltd 01-01-2022; Medknow Publications and Media Pvt. Ltd; Medknow Publications & Media Pvt. Ltd
• Subjects: Antimitotic agents; Antineoplastic agents; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Cancer; Cancer therapies; Capecitabine - adverse effects; Care and treatment; Colorectal cancer; Colorectal Neoplasms - drug therapy; Fluorouracil - adverse effects; Humans; Observational studies; Oncology, Experimental; Oxaliplatin - therapeutic use; Rectal Neoplasms - drug therapy; Toxicity; India; CAPOX; response; Colorectal cancer; survival; toxicities; tertiary care center; south Indian patientsKey Message CAPOX regimen was found to be effective in the management of colorectal cancer in a real world nonclinical trial setting. The toxicities associated with the treatment were manageable; south Indian patients
• ISSN: 0019-509X; 1998-4774
• DOI: 10.4103/ijc.IJC_618_19

Background: 5-fluorouracil (5-FU) was the standard treatment care for colorectal cancer (CRC), however, its efficacy was limited due to safety concerns. Capecitabine and oxaliplatin (CAPOX) treatment was found equivalent to 5-FU in efficacy and preferred now due to easy management and convenience in administration. Hence, the present study aims to determine the efficacy and safety associated with CAPOX treatment in a real world non clinical setting.
Methods: 145 treatment-naive and newly diagnosed CRC patients were recruited in the study. Each patient received oxaliplatin 130 mg/m2 infusion over 2 hours on day 1 and oral capecitabine 1000 mg/m2 in divided doses twice daily for the next 14 days of a 21-day cycle.
Results: In the adjuvant setting, the observed disease-free survival rate was 62% (n=34) in the colon and 67% (n=15) in the rectum cancer patients at 2 years. The observed overall survival rate in the colon and rectal cancer was 80% (n=44) and 83% (n=18) respectively at 2 years. In the palliative setting the observed progression-free survival rate was 28% (n=13) in the colon and 33% (n=7) in rectal cancer patients at 2 years. The observed OSR at 2 years was 64% (n=30) in the colon and 67% (n=14) in the rectal cancer patients. Thrombocytopenia (17, 11.7%) and diarrhea (8, 5.5%) were the most commonly observed grade 3/4 hematological and gastrointestinal toxicities. Hand-foot syndrome and peripheral neuropathy were the major contributors for dose reduction (14, 9.6%), treatment delay (8, 5.4%), and drug discontinuation (9, 6.1%) in the study cohort.
Conclusion: CAPOX treatment was found to be effective but associated with several dose-limiting toxicities.