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Systemic Anti-Cancer Therapy Regimen Library

Home > CRC Metastatic - mCAPIRI

CRC Metastatic - mCAPIRI

Treatment Overview

Cycle 1 (and all further cycles) - 21 days

Cycle length:
21

Cycle details

Cycle 1 (and all further cycles) - 21 days

Medication Dose Route Days Max Duration
ondansetron 8 mg oral administration 1
dexamethasone * 8 mg oral administration 1, 2, 3
atropine sulfate * 600 microgram intravenous 1 2 minutes
irinotecan * 200 mg/m² intravenous 1 90 minutes
capecitabine * 800 mg/m² Twice daily oral administration 1 to 14
ondansetron 8 mg oral administration 1
domperidone 10 mg Three times daily oral administration 1
loperamide 2 mg oral administration 1

Full details

Cycle 1 (and all further cycles) - 21 days

Day: 1

Medication Dose Route Max duration Details
ondansetron 8 mg oral administration
Instructions:
ONE hour prior to chemotherapy.
dexamethasone * 8 mg oral administration
Instructions:
ONE hour prior to chemotherapy with food.
atropine sulfate * 600 microgram intravenous 2 minutes
Instructions:
600 microgram = 0.6 mg. Some centres may wish to give a reduced dose of 300 micrograms (= 0.3 mg) in line with institutional policy.
irinotecan * 200 mg/m² intravenous 90 minutes
capecitabine * 800 mg/m² Twice daily oral administration
Instructions:
Take each dose with food and a large glass of water. Round dose to closest multiple of 150 mg and/or 500 mg tablets.
ondansetron 8 mg oral administration
Instructions:
EIGHT hours after chemotherapy or before bed.
domperidone 10 mg Three times daily oral administration
Instructions:
When required for nausea and/or vomiting.
loperamide 2 mg oral administration
Instructions:
Take TWO capsules (=4 mg) at onset of loose bowel motions and a further ONE capsule (=2 mg) for every loose bowel motion (maximum of EIGHT capsules in 24 hours), or use as directed by oncologist or haematologist.

Day: 2

Medication Dose Route Max duration Details
dexamethasone * 8 mg oral administration
Instructions:
ONCE daily in the morning with food.
capecitabine * 800 mg/m² Twice daily oral administration
Instructions:
Take each dose with food and a large glass of water. Round dose to closest multiple of 150 mg and/or 500 mg tablets.

Day: 3

Medication Dose Route Max duration Details
dexamethasone * 8 mg oral administration
Instructions:
ONCE daily in the morning with food.
capecitabine * 800 mg/m² Twice daily oral administration
Instructions:
Take each dose with food and a large glass of water. Round dose to closest multiple of 150 mg and/or 500 mg tablets.

Day: 4

Medication Dose Route Max duration Details
capecitabine * 800 mg/m² Twice daily oral administration
Instructions:
Take each dose with food and a large glass of water. Round dose to closest multiple of 150 mg and/or 500 mg tablets.

Day: 5

Medication Dose Route Max duration Details
capecitabine * 800 mg/m² Twice daily oral administration
Instructions:
Take each dose with food and a large glass of water. Round dose to closest multiple of 150 mg and/or 500 mg tablets.

Day: 6

Medication Dose Route Max duration Details
capecitabine * 800 mg/m² Twice daily oral administration
Instructions:
Take each dose with food and a large glass of water. Round dose to closest multiple of 150 mg and/or 500 mg tablets.

Day: 7

Medication Dose Route Max duration Details
capecitabine * 800 mg/m² Twice daily oral administration
Instructions:
Take each dose with food and a large glass of water. Round dose to closest multiple of 150 mg and/or 500 mg tablets.

Day: 8

Medication Dose Route Max duration Details
capecitabine * 800 mg/m² Twice daily oral administration
Instructions:
Take each dose with food and a large glass of water. Round dose to closest multiple of 150 mg and/or 500 mg tablets.

Day: 9

Medication Dose Route Max duration Details
capecitabine * 800 mg/m² Twice daily oral administration
Instructions:
Take each dose with food and a large glass of water. Round dose to closest multiple of 150 mg and/or 500 mg tablets.

Day: 10

Medication Dose Route Max duration Details
capecitabine * 800 mg/m² Twice daily oral administration
Instructions:
Take each dose with food and a large glass of water. Round dose to closest multiple of 150 mg and/or 500 mg tablets.

Day: 11

Medication Dose Route Max duration Details
capecitabine * 800 mg/m² Twice daily oral administration
Instructions:
Take each dose with food and a large glass of water. Round dose to closest multiple of 150 mg and/or 500 mg tablets.

Day: 12

Medication Dose Route Max duration Details
capecitabine * 800 mg/m² Twice daily oral administration
Instructions:
Take each dose with food and a large glass of water. Round dose to closest multiple of 150 mg and/or 500 mg tablets.

Day: 13

Medication Dose Route Max duration Details
capecitabine * 800 mg/m² Twice daily oral administration
Instructions:
Take each dose with food and a large glass of water. Round dose to closest multiple of 150 mg and/or 500 mg tablets.

Day: 14

Medication Dose Route Max duration Details
capecitabine * 800 mg/m² Twice daily oral administration
Instructions:
Take each dose with food and a large glass of water. Round dose to closest multiple of 150 mg and/or 500 mg tablets.

Supportive Care Factors

Factor Value
Diarrhoea risk: Anti-diarrhoeals are usually prescribed with this treatment
Emetogenicity: Medium
Hypersensitivity / Infusion related reaction risk: Low - routine premedication not recommended

References

1. Xu RH, Muro K, Morita S et al. Modified XELIRI (capecitabine plus irinotecan) versus FOLFIRI (leucovorin, fluorouracil, and irinotecan), both either with or without bevacizumab, as second‐line therapy for metastatic colorectal cancer (AXEPT): A multicentre, open‐label, randomised, non‐inferiority, phase 3 trial. Lancet Oncol 2018; 9: 660– 71., PMID: 29555258

2. Patt YZ, Lin E, Liebman J, et al. Capecitabine plus irinotecan: A highly active first-line treatment for metastatic colorectal cancer. Proc Am Soc Clin Oncol 2003;22:281a (abstract 1130).

3. Kerr DJ, Ten Bokkel Huinink WW, Ferry DR, et al. A phase I/II study of CPT-11 in combination with capecitabine as first line chemotherapy for metastatic colorectal cancer. Proc Am Soc Clin Oncol 2002;21:100a (abstract 643).

4. Delord P, Pierga JY, Dieras V, et al. Dose escalation and pharmacokinetic study of capecitabine (Xeloda) and irinotecan (CPT11) in gastro-intestinal tumors: preliminary results. Proc Am Soc Clin Oncol 2002;21:100a (abstract 397).

5. Bajetta E, Di Bartolomeo M, Mariani L, et al. Randomized multicenter Phase II trial of two different schedules of irinotecan combined with capecitabine as first-line treatment in metastatic colorectal carcinoma. Cancer 2004;100(2):279-87. , PMID: 14716761

6. Wasserman E, Myara A, Lokiec F, et al. Severe CPT-11 toxicity in patients with Gilbert's syndrome: two case reports. Ann Oncol 1997;8(10):1049-51. , PMID: 9402181

* The medicines, doses, combinations, and schedule in this treatment regimen have been carefully reviewed against international best practice guidelines by specialists in medical oncology around New Zealand and this advice has been accepted for publication by Te Aho o Te Kahu (the Cancer Control Agency). Sometimes medicines that are used in routine clinical practice have not been through a formal review process by the NZ Medicines Regulator Medsafe and are therefore considered unapproved or off-label. These medicines are legally able to be prescribed through sections 25 and 29 of the Medicines Act and by obtaining informed consent from patients. All treatment regimens listed on this website have been through robust peer review and are considered an accepted standard of care, whether prescribed through sections 25 or 29 or carrying formal Medsafe Approval.

s29: This symbol indicates that some formulations of the associated medicine are legally only able to be prescribed under section 29 of the Medicines Act. You can see which formulations are section 29 by hovering over the s29 symbol. You can access full medication details from the New Zealand Formulary by clicking on the medication name. Each clinician retains full responsibility for ensuring they have complied with all relevant obligations and requirements of section 29 including obtaining informed patient consent prior to prescribing the applicable medicine.