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Systemic Anti-Cancer Therapy Regimen Library

Home > UGI GAST AND OES Metastatic - CAPOX [capecitabine and oxaliplatin]

UGI GAST AND OES Metastatic - CAPOX [capecitabine and oxaliplatin]

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
dexamethasone * 8 mg oral administration 1, 2, 3
ondansetron 8 mg oral administration 1
oxaliplatin * 130 mg/m² intravenous 1 120 minutes
capecitabine * 1000 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
dexamethasone * 8 mg oral administration
Instructions:
ONE hour prior to chemotherapy with food.
ondansetron 8 mg oral administration
Instructions:
ONE hour prior to chemotherapy.
oxaliplatin * 130 mg/m² intravenous 120 minutes
Instructions:
Usual infusion time of two hours may be extended to up to 6 hours if needed to reduce likelihood and/or severity of adverse reactions. Hypersensitivity risk increases with number of cycles of oxaliplatin.
capecitabine * 1000 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. The choice of rescue antiemetic may be substituted to reflect institutional policy or individual patient characteristics.
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 * 1000 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 * 1000 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 * 1000 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 * 1000 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 * 1000 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 * 1000 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 * 1000 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 * 1000 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 * 1000 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 * 1000 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 * 1000 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 * 1000 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 * 1000 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. Jatoi, A., B. R. Murphy, N. R. Foster, et al. 2006. "Oxaliplatin and capecitabine in patients with metastatic adenocarcinoma of the esophagus, gastroesophageal junction and gastric cardia: a phase II study from the North Central Cancer Treatment Group." Ann Oncol 17(1):29-34., PMID: 16303863

2. Cunningham, D., A. F. Okines and S. Ashley. 2010. "Capecitabine and oxaliplatin for advanced esophagogastric cancer." N Engl J Med 362(9):858-859., PMID: 20200397

3. Dong, N., W. Jiang, H. Li, et al. 2009. "Triweekly oxaliplatin plus oral capecitabine as first-line chemotherapy in elderly patients with advanced gastric cancer." Am J Clin Oncol 32(6):559-563., PMID: 19581793

4. Okines, A. F. C., A. R. Norman, P. McCloud, et al. 2009. "Meta-analysis of the REAL-2 and ML17032 trials: evaluating capecitabine-based combination chemotherapy and infused 5-fluorouracil-based combination chemotherapy for the treatment of advanced oesophago-gastric cancer." Ann Oncol 20(9):1529-1534., PMID: 19474114

5. Park, Y. H., J. L. Lee, B. Y. Ryoo, et al. 2008. “Capecitabine in combination with Oxaliplatin (XELOX) as a first-line therapy for advanced gastric cancer.” Cancer Chemother Pharmacol 61(4):623-629., PMID: 17522863

6. Liu, C., Q. Sun, X. Hang, et al. 2008. "Multicenter phase II study of capecitabine plus oxaliplatin as a first-line therapy in Chinese patients with advanced gastric cancer." Anticancer Drugs 19(8):825-831., PMID: 18690095

7. Van Meerten, E., F. A. Eskens, E. C. van Gameren, et al. 2007. “First-line treatment with oxaliplatin and capecitabine in patients with advanced or metastatic oesophageal cancer: a phase II study.” Br J Cancer 96(9):1348-1352., PMID: 17437008

8. Park, Y. H., B. S. Kim, B. Y. Ryoo, et al. 2006. "A phase II study of capecitabine plus 3-weekly oxaliplatin as first-line therapy for patients with advanced gastric cancer." Br J Cancer 94(7):959-963., PMID: 16552439

9. Pharmacy Retailing (NZ) limited t/a Healthcare Logistics. Oxaliplatin Accord New Zealand Data Sheet. https://www.medsafe.govt.nz/profs/Datasheet/o/oxaliccordinf.pdf (Accessed 16 February 2021).

10. National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) Gastric Cancer Version 1.2021. https://www.nccn.org/professionals/physician_gls/pdf/gastric.pdf (Accessed 15 February 2021).

11. Dr Reddy’s New Zealand Ltd. Capercit New Zealand Data Sheet. https://www.medsafe.govt.nz/profs/Datasheet/c/capercittab.pdf (Accessed 16 February 2021).

12. Boulanger J, Boursiquot JN, Cournoyer G, et al. Management of hypersensitivity to platinum- and taxane-based chemotherapy: cepo review and clinical recommendations. Curr Oncol. 2014;21(4):e630-e641. , PMID: 25089112

13. Castells, M.C., Matulonis, U.A., and Horton, TM. Infusion reactions to systemic chemotherapy. Savarese DMF and Feldweg AM, ed. UpToDate. Waltham, MA: UpToDate Inc. https://www.uptodate.com (Accessed 26 March 2021).

* 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.