What is the role of combined capecitabine and oxaliplatin (XELOX) in treatment of advanced unresectable gastric cancer?

Updated: May 21, 2019
  • Author: Elwyn C Cabebe, MD; Chief Editor: N Joseph Espat, MD, MS, FACS  more...
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Answer

A more recent study suggests that survival in advanced gastric cancer is also improved with an adjuvant chemotherapy regimen. Data from the open-label randomized Capecitabine and Oxaliplatin Adjuvant Study in Stomach Cancer (CLASSIC) indicate that after surgery for advanced gastric cancer, treatment with capecitabine and oxaliplatin (XELOX) cuts the risk of death by 34% over 5 years, as compared with surgery alone. [56, 57]

In the CLASSIC study, patients with stage II to IIIB gastric cancer who had undergone curative D2 gastrectomy were assigned to adjuvant XELOX for eight cycles or surgery alone. The XELOX regimen consisted of oral capecitabine (1000 mg/m² twice daily on days 1-14 of each cycle) plus intravenous oxaliplatin (130 mg/m² on day 1 of each cycle) for 6 months. [56, 57]

At 5 years there was a 34% reduction in the risk of death with XELOX, as compared with surgery alone. [56, 57] The 5-year overall survival rate was also better with XELOX (78% vs 69%), as well as the 5-year disease-free survival rate (68% with XELOX and 53% without).


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