Capecitabine (Xeloda): Oral Chemotherapy for Colon & Breast Cancer
Capecitabine acts like a "Trojan Horse" for cancer treatment. It is an oral prodrug, meaning it is not active when you swallow it. Once inside the body, it converts into a powerful cancer-killing agent (5-Fluorouracil) predominantly inside the tumor tissue.
This happens because cancer cells contain higher levels of the specific enzyme needed to activate the drug compared to healthy cells. Capecitabine (Xeloda) allows patients to receive effective chemotherapy at home via tablets, avoiding the need for permanent IV lines and long hospital stays.
It is a cornerstone therapy for colorectal, gastric, and breast cancers.
Indications
- Colorectal Cancer: Used after surgery (adjuvant) to prevent recurrence in colon cancer, and as a treatment for metastatic colorectal cancer.
- Breast Cancer: For locally advanced or metastatic breast cancer resistant to paclitaxel and anthracyclines. Often used in combination with docetaxel.
- Gastric Cancer: First-line treatment for advanced stomach cancer.
Dosage and administration
Dosage is calculated by body surface area. The most common schedule involves cycles.
- The "14-Day" Cycle: Take tablets twice daily (morning and evening) for 14 consecutive days, followed by a 7-day rest period. This completes one 21-day cycle.
- Crucial Instruction: Take the tablets within 30 minutes AFTER a meal with water. This reduces nausea and ensures proper absorption.
- DPD Deficiency: Complete absence of dihydropyrimidine dehydrogenase activity. This genetic condition prevents the body from breaking down the drug, leading to life-threatening toxicity.
- Severe renal impairment.
- Pregnancy and breastfeeding.
The signature side effect affects the hands and feet.
- Hand-Foot Syndrome (Very Common): Redness, swelling, numbness, and peeling of the palms and soles. Moisturizing heavily with urea-based creams and wearing comfortable shoes is essential from day one.
- Digestive: Diarrhea, nausea, vomiting, stomatitis (mouth sores).
- General: Fatigue and weakness.
