Capecitabine and oxaliplatin in advanced colorectal cancer: A dose-finding study

Purpose: Capecitabine and oxaliplatin are both active anticancer agents in the treatment of patients with advanced colorectal cancer (ACRC). The aim of this dose-finding trial was to determine the maximum-tolerated dose (MTD), the dose-limiting toxicities (DLTs) and the activity of the combination in patients with advanced colorectal cancer. Patients and methods: Twenty-five chemotherapy-pretreated patients received the combination of capecitabine and oxaliplatin. Capecitabine was administered orally twice a day continuously for 14 days in doses ranging from 1650 to 2500 mg/m(2)/d, and oxaliplatin was administered as a two-hour infusion on day 1 using dose, ranges from 100 to 130 mg/m(2) repeated every three weeks. Results: Twenty-five patients were assessable for toxicity, and DLTs were diarrhea (grade greater than or equal to3: 27%) and stomatitis (grade greater than or equal to3: 9%) at dose level VI. Dose level V (capecitabine 2500 mg/m(2) and oxaliplatin 120 mg/m(2)) was found to be the MTD. Hematological toxicity was minimal, overall neurotoxicity (grade 1-4) was 27% with 1% grade 3-4. A global response rate was 17% (95% confidence interval (95% CI): 2%-32%) and the median overall survival was 12 months. Conclusion: The recommended dose for further phase II studies is capecitabine 2500 mg/m(2)/d with intermittent schedule and oxaliplatin 120 mg/m(2) every three weeks. The toxicities were mainly gastrointestinal: diarrhea, stomatitis and vomiting. This combination should be studied in phase II trials in advanced colorectal.