Capecitabine versus Bolus Capecitabine versus Bolus 5-FU/Leucovorin as Adjuvant Therapy 5-FU/Leucovorin as Adjuvant Therapy for Colon Cancer: X-ACT Trial for Colon Cancer: X-ACT Trial Results Results James Cassidy, MD Colorectal Cancer Update Think Tank Meeting June 24, 2005
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Capecitabine versus Bolus 5-FU/Leucovorin as Adjuvant Therapy for Colon Cancer: X-ACT Trial Results James Cassidy, MD Colorectal Cancer Update Think Tank.
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Capecitabine versus Bolus Capecitabine versus Bolus 5-FU/Leucovorin as Adjuvant Therapy for 5-FU/Leucovorin as Adjuvant Therapy for
X-ACT: Quality of Life Maintained Over Time X-ACT: Quality of Life Maintained Over Time (QLQ C-30)(QLQ C-30)
5-FU / LVCapecitabine
100
80
60
40
20
0Baseline 7 9 16 17 25
Weeks (of trial treatment)
889 817 894 912841 746 838 865
n = n =
Glo
bal
hea
lth
sta
tus
sco
re
Source: Cassidy J. Presentation. Colorectal Cancer Update Think Tank Meeting 2005.
*Also balanced first- versus second-line chemotherapy
Poststudy Chemotherapy after RelapsePoststudy Chemotherapy after RelapseSimilar in Both ArmsSimilar in Both Arms
Percent patients with chemotherapy*
Capecitabinen = 372
5-FU/LVn = 404
Regimens based on:
5-FU 17 16
Irinotecan 39 35
Oxaliplatin 32 29
Capecitabine 4 10
Others 9 6
-1864
1450
-3004
-57 -259
7
Net costs per patient versus 5-FU/LV (£)
4 000
2 000
0
–2 000
–4 000
Total Drugs Administration Hospital Medications Consultations use
Sources: Updated from Douillard J-Y et al. Ann Oncol 2004;15(Suppl 3):iii73; Cassidy J. Presentation. Colorectal Cancer Update Think Tank Meeting 2005.
Replacement of 5-FU/LV with Xeloda is Net Cost Replacement of 5-FU/LV with Xeloda is Net Cost Saving: Direct Payer CostsSaving: Direct Payer Costs
X-ACT Trial ConclusionsX-ACT Trial Conclusions
Disease-free survival for capecitabine at least equivalent to 5-FU/leucovorin
Capecitabine improved relapse-free survival
Capecitabine associated with significantly fewer adverse events
Capecitabine is an effective alternative to IV 5-FU/leucovorin as adjuvant therapy in patients with Stage III disease