Capecitabine in older metastatic colorectal cancer patients

This study investigated the safety and effectiveness of capecitabine (Xeloda) as treatment for advanced colorectal cancer in patients 75 or more years old. Researchers suggested that this drug was effective in patients aged 75 or older with colorectal cancer, with manageable side effects. 

Chemotherapy has been the most common treatment for colorectal cancer for four decades. Chemotherapy agents attack cancer cells, slowing down cancer progression. However, chemotherapy has generally been delivered through catheters or ports into the vein, as has required delivery in a hospital setting. The development of the chemotherapy capecitabine tablets made receiving the treatment easier.  Prior studies have shown that this treatment is effective in colorectal cancer patients. However, studies with elderly patients are limited. 

This study investigated the safety and effectiveness of capecitabine as first-line treatment of metastatic (spread to other parts of the body) colorectal cancer patients aged 75 years or older. This study included 1249 patients. 580 patients (46%) were treated with capecitabine alone and the other 668 (54%) received a combination of capecitabine with other agent. The average treatment duration was 5.3 months. 

Overall, average time to disease progression was 8.2 months for patients older than 75 compared to 9.7 months in patients younger than 75. Patients treated with the combination had a 12% improvement in the odds of a longer time to disease progression, with no difference in overall survival (time from treatment until death from any cause. Average overall survival was 22.6 months in patients older than 75 compared to 31 months in patients younger than 75.

Common non-severe negative side effects were anemia (lower than the normal number of red blood cells), hand-foot syndrome (swelling and pain of hands and/or feet) and gastrointestinal effects (nausea and diarrhea). Severe side effects rarely occurred (3% of patients). There were no differences in the different age groups.

This study concluded that a capecitabine alone or in combination is an option for the treatment of metastatic colorectal cancer in patients with 75 or more years old. The negative effects of the treatment were manageable.

Discuss with your physician treatment with capecitabine.