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

Table 4 Comparison of treatment safety (Grade 3/4 events) in combination with oxaliplatin

Clinical trial	Treatments	Diarrhea	Mucositis/stomatitis	Neutropenia	HFS	Vomiting (%)
Díaz-Rubio et al[20] (2007)	XELOX vs FUOX	14% vs 24%a	2% vs 4%	7% vs 11%	2% vs 1%	5% vs 8%
Cassidy et al[21] (2008)	XELOX vs FOLFOX-4 +/- Bev	19% vs 11%	1% vs 2%	7% vs 44%	6% vs 1%	5% vs 4%
Ducreux et al[9] (2011)	XELOX vs FOLFOX-6	14% vs 7%a	0% vs 1%	5% vs 47%a	3% vs 1%	2% vs 5%
Porschen et al[22] (2007)	CAPOX vs FUFOX	15% vs 14%	1% vs 3%	-	10% vs 4%c	6% vs 6%
Comella et al[23] (2009)	OXXEL vs OXAFAFU	13% vs 8%	2% vs 2%	10% vs 27%e	4% vs 1%	3% vs 8%e
Hochster et al[25] (2008)	XELOX vs FOLFOX-6 vs bFOL	31% vs 31% vs 26%	-	15% vs 53% vs 18%	19% vs 8% vs 2%	38% vs 31% vs 24%
	+ Bev1	19% vs 11% vs 26%	-	10% vs 49% vs 19%	10% vs 0% vs 0%	21% vs 7% vs 24%

¹Reduced XELOX dose (850 mg/m² capecitabine). 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. Bev: Bevacizumab; HFS: Hand-foot syndrome.

^aP < 0.05 vs XELOX;

^cP < 0.05 vs CAPOX;

^eP < 0.05 vs OXXEL.