What is CAPEOX?
- CAPEOX = Capecitabine + Oxaliplatin
- Oral–IV doublet regimen used as an alternative to FOLFOX.
Drug Components & Dosing
- Oxaliplatin: 130 mg/m² IV over 2 hours on Day 1
- Capecitabine: 850–1000 mg/m² PO BID, on Days 1–14
- Cycle length: every 21 days
Some trials used 1000 mg/m² BID, but in practice 850 mg/m² BID is often used to reduce hand–foot syndrome.
Indications
- Colorectal cancer (CRC):
- Adjuvant therapy in stage III colon cancer.
- First-line therapy in metastatic CRC.
- Gastric & gastroesophageal junction cancers: often used perioperatively or metastatic.
- Pancreatic, biliary tract cancers: studied/used in certain settings.
Toxicities
- Oxaliplatin-related:
- Peripheral neuropathy (acute cold-induced + cumulative sensory).
- Myelosuppression.
- Capecitabine-related:
- Hand–foot syndrome (palmar-plantar erythrodysesthesia).
- Diarrhea, mucositis.
- Myelosuppression.
- General: nausea, vomiting, fatigue.
Monitoring
- CBC, renal, and hepatic function before each cycle.
- Neuropathy assessment.
- Watch for diarrhea, hand–foot syndrome.
- Dose adjust capecitabine for renal impairment (CrCl <50 mL/min).
Clinical Notes
- CAPEOX is often preferred over FOLFOX for convenience (oral capecitabine vs. infusional 5-FU pump).
- Not given to patients with significant renal dysfunction (since capecitabine is renally cleared).
- Trials: