XELOX chemotherapy is the first line of treatment for advanced or metastatic colorectal cancer. This is also called CAPOX chemotherapy. This is an effective treatment as it slows down disease progression. It is a combination of two drugs- Oxaliplatin and Xeloda that is a trade name for Capecitabine. This is normally given on an outpatient basis. The patient usually has a blood test done prior to the treatment to check the blood counts.

XELOX Chemotherapy Cycle

In this, oxaliplatin is a colorless fluid administered intravenously through an IV tube or through a PICC line if it is fitted. This infusion goes on for about two hours after which the patient can go home. Capecitabine is given in the form of tablets that are usually a combination of 500mg and 150 mg that the patient can take at home along with a glass of water. This should be taken after a meal especially one after the breakfast and one after the evening meal so that there is gap of about 8-12 hours in between two doses, which is essential. These are peach colored tablets. This oral dose begins the same day after oxaliplatin infusion. These tablets are taken for 14 days. For the next seven days, there is no medication. This is called recovery period. This completes 1 cycle of 21 days. Like this there are 4-8 cycles done in a span of 3-9 months. This completes entire XELOX treatment.

Before infusion of oxaliplatin, the patient would be given anti emetic medicines either through IV or orally. This is to prevent nausea and vomiting that is a common side effect of most chemotherapy drugs.

The Way These Drugs Work

Capecitabine is an antimetabolite. Antimetabolites resemble the normal substances within the cell. When these drugs are incorporated into the cellular metabolism, the cells are unable to divide. Antimetabolites are cell cycle specific i.e. they act in specific phases of mitosis or the cell division process.

Oxaliplatin is an alkylating agent. Alkylating agents act aggressively in the resting phase of the cell. Hence, these drugs are not restricted to any specific phase of the cell division process. Hence, when chemotherapy with oxaliplatin is given, its acts when the cell is not dividing.

Xeloda is used along with Taxotere i.e. docetaxel, in the treatment of breast cancer in the metastatic stage, that is breast cancer that has spread to other organs after IV chemotherapy using anthracyclines. Xeloda chemotherapy is used as a single drug treatment for metastatic breast cancer that is resistant to other chemotherapy drugs like paclitaxel and anthracyclines.

It is also used to treat advanced pancreatic cancer.

Side Effects of XELOX Chemotherapy

Some of the most common side effects of XELOX are diarrhea, abdominal pain, nausea, stomatitis and hand-foot syndrome. Most of these can be controlled before hand through medications prescribed by your doctor.

There have not been too many side effects of chemotherapy reported, except that this drug should not be administered if the patient is on some other medication as this could result in adverse effects and even sudden death.

It is important that the doctor is aware of the entire case history of the patient including all kinds of medication the patient is taking or has taken in the past. This includes OTC and prescribed medication, alternative therapies, herbal medicines, etc.

XELOX chemotherapy so far has been very effective with fewer side effects and hence is preferred by many doctors for chemotherapy for colorectal cancer. Normally, most patients have a progression free survival i.e. the disease does not progress further and this improves the quality of life.