Should capecitabine replace 5-fluorouracil in the first-line treatment of metastatic colorectal cancer?

Table 3 Comparison of treatment efficacy in combination with oxaliplatin

Clinical trial	Type	Treatment	ORR	PFS (mo)	OS (mo)
Díaz-Rubio et al[20] (2007)	Phase III	XELOX vs FUOX	37% vs 46% (P = 0.154)	8.9 vs 9.5 (HR = 1.18, P = 0.153)	18.1 vs 20.8 (HR 1.22, P = 0.145)
Cassidy et al[45] (2008)	Phase III	XELOX vs FOLFOX-4+/- Bev	47% vs 48% (OR 0.94)	8 vs 8.5 (HR = 1.04)1	19.8 vs 19.6 (HR = 0.99)
Ducreux et al[42] (2011)	Phase III	XELOX vs FOLFOX-6	42% vs 46%	8.8 vs 9.3 (HR = 1)	19.9 vs 20.5 (HR = 1.02)
Porschen et al[22] (2007)	Phase III	CAPOX vs FUFOX	48% vs 54% (P = 0.7)	7.1 vs 8.0 (HR = 1.17, P = 0.117)	16.8 vs 18.8 (HR = 1.12, P = 0.26)
Comella et al[23] (2009)	Phase III	OXXEL vs OXAFAFU	34% vs 33% (P = 0.999)	6.6 vs 6.5 (HR = 1.12, P = 0.354)	16.0 vs 17.1 (HR = 1.01, P = 0.883)
Hochster et al[25] (2008)	Phase II	XELOX vs FOLFOX-6 vs bFOL+ Bev	27% vs 41% vs 20%; 46% vs 52% vs 39%	5.9 vs 8.7 vs 6.9; 10.3 vs 9.9 vs 8.3	17.2 vs 19.2 vs 17.9; 24.6 vs 26.1 vs 20.4

Treatments: XELOX: Capecitabine 1000 mg/m² every 12 h (days 1-14) + 130 mg/m² oxaliplatin (day 1), 3-wk regimen cycle; FUOX: 2250 mg/m² 5-FU continuous infusion for 48 h (days 1, 8, 15, 22, 29 and 36) + 85 mg/m² oxaliplatin (days 1, 15 and 29) 6-wk regimen cycle; FOLFOX-4: 400 mg/m² 5-FU bolus + 200 mg/m² LV + 600 mg/m² continuous infusion 5-FU for 22 h (days 1 and 2) + oxaliplatin 85 mg/m² (day 1) 2-wk regimen cycle, FOLFOX-6: 400 mg/m² 5-FU bolus + 400 mg/m² LV + 2400 mg/m² 46 h 5-FU continuous infusion + 100 mg/m² oxaliplatin (day 1), 2-wk regimen cycle); CAPOX: 1000 mg/m² capecitabine every 12 h (days 1-14) + 70 mg/m² oxaliplatin (days 1 and 8, 3-wk regimen cycle; FUFOX: 500 mg/m² LV + 50 mg/m² oxaliplatin + 2000 mg/m² 5-FU continuous infusion for 22 h (days 1, 8, 15 and 22), 5-wk regimen cycle; OXXEL: 1000 mg/m² capecitabine every 12 h (days 1-11) + 100 mg/m² oxaliplatin (day 1), 2-wk regimen cycle; OXAFAFU: 250 mg/m² LV + 85 mg/m² oxaliplatin (day 1) + 850 mg/m² 5-FU bolus (day 2), 2-wk regimen cycle; bFOL: 20 mg/m² LV + 85 mg/m² oxaliplatin (days 1 and 15) + 500 mg/m² 5-FU bolus (days 1 and 8-15), 4-wk regimen cycle. ORR: Overall response rate; PFS: Progression-free survival; OS: Overall survival; HR: Hazard ratio; Bev: Bevacizumab.

¹Significant PFS difference between XELOX + bevacizumab (HR = 0.77, P = 0.0026).