Capecitabine Plus Irinotecan Versus 5-FU/Leucovorin Plus Irinotecan in the Treatment of Colorectal Cancer: A Meta-analysis

Comparison of the efficacy and safety of the XELIRI (capecitabine with irinotecan) regimen and FOLFIRI (5-fluorouracil with irinotecan) regimen in the treatment of metastatic colorectal cancer (mCRC) often shows conflicting results. After identifying 6 studies from databases, we found no significant difference in overall response rate (ORR), progression-free survival (PFS), or overall survival (OS) between XELIRI and FOLFIRI, suggesting that both are appropriate first-line treatment options. Background: The XELIRI regimen and FOLFIRI regimen are used as the first-line treatment of metastatic colorectal cancer. A comparison of findings from different studies that examined the efficacy and safety of these 2 regimens often show conflicting results. This metaanalysis compared the XELIRI and FOLFIRI regimens in the treatment of mCRC. Patients and Methods: Six studies comparing the safety and efficacy of XELIRI- and FOLFIRI-based treatment of mCRC were identified from MEDLINE, Cochrane, EMBASE, and Google Scholar (until January 31, 2013) databases. Results: No significant difference in ORR, PFS, or OS between XELIRI and FOLFIRI as first-line therapy in patients with colorectal cancer was found in this analysis. Except for XELIRI being associated with a higher incidence of diarrhea, both treatment regimens had similar safety profiles. Conclusion: Both XELIRI and FOLFIRI regimens had similar efficacy as first-line treatment in patients with mCRC with similar adverse event profiles. Our findings suggest that XELIRI and FOLFIRI are appropriate first-line treatment options for mCRC patients.