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Elderly or Compromised Patients Do Better with Capecitabine in Advanced Colorectal Cancer: Presented at ASCO-GI
By Roberta Friedman, PhD
SAN FRANCISCO, CA -- January 26, 2004 -- Single agent therapy with the oral drug capecitabine can treat advanced colorectal cancer effectively and gently for patients who are elderly or who have compromised function.
Findings of a Phase I/II trial, carried out at several Canadian centers, were presented here January 24th at the First Annual Gastrointestinal Cancers Symposium, sponsored jointly by the American Society of Clinical Oncology and other societies.
Study investigator Derek Jonker, MD, Ottawa Regional Cancer Center, Ottawa, Ontario, said a sequential chemotherapy regimen is easier on such patients than commonly used combination regimens, and "we still have efficacy, with 73% disease control" in patients who took the single agent.
Use of the study drug was associated with less toxicity, Dr. Jonker added. Of 93 evaluable patients, 24 had grade 3 or 4 toxicities. Expected rate of this degree of toxicity is about 35%, Dr. Jonker said.
The study recruited patients with advanced colorectal cancer, in five risk categories: age above 65 years, Eastern Cooperative Oncology Group (ECOG) performance status of 1 or greater, prior pelvic radiation, elevated lactate dehydrogenase (LDH) levels, or liver enzymes.
Patients received capecitabine at a dose of 2000 mg/m2 daily for 2 weeks every 21 days. A median of four cycles was given so far in this ongoing trial.
Combination therapy is preferred for young, fit patients, Dr. Jonker said, but can be quite toxic for older or impaired patients. The single agent regimen with capecitabine "is clearly well tolerated," he added, with a "respectable median survival of 17.4 months."
Hoffman-LaRoche funded the study.
[Study title: Dose-reduced first-line capecitabine monotherapy in older and less fit patients with advanced colorectal cancer (ACRC). Abstract OP212]
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