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New treatment schedule for Xeloda?

Page last modified on: August 1, 2008
Question from Joan: I've been on Xeloda for a year now and it is working, but the side effects are somewhat debilitating — hand-foot syndrome. What do you consider to be a good schedule for the drug — 7 days on, 7 days off at a higher dose? I understand that this is a new protocol.
Answer —Larry Norton, M.D.: Yes, that's a treatment that we've developed at Memorial Sloan-Kettering. The conventional schedule for Xeloda (chemical name: capecitabine) is 14 days on and 7 days off. However, by analyzing lab experiments, we have determined that most of the cancer killing activity of the drug is in the first 7 days of exposure. Hence we have explored 7 days on and 7 days off instead of 14 days on and 7 days off. This allows a higher dose to be administered safely, and seems to remarkably reduce the incidence of hand-foot syndrome. Currently this regimen is being tested in various settings; however, because of the reduction in toxicity many oncologists are already using the 7 on/7 off schedule as their preferred method of administration. The important thing is to stay away from the drug until the hand-foot heals completely. You can go to other anti-cancer medications for weeks or months until the hand-foot syndrome heals, and then go back to the Xeloda with the new schedule and get anti-cancer activity with reduced side effects.

On Wednesday, October 17, 2007 our Ask-the-Expert Online Conference was called Living with Metastatic Breast Cancer. Larry Norton, M.D. and moderator Marisa Weiss, M.D. answered your questions about managing day-to-day life with metastatic breast cancer.

The materials presented in these conferences do not necessarily reflect the views of breastcancer.org. A qualified healthcare professional should be consulted before using any therapeutic product or regimen discussed. All readers should verify all information and data before employing any therapies described here.

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Meet the Experts

Larry Norton, M.D.Larry Norton, M.D. is deputy physician-in-chief and director of Breast Cancer Programs at Memorial Sloan-Kettering Cancer Center in New York City.

Marisa Weiss, M.D. is a radiation oncologist specializing in breast cancer and the founder, president, and guiding force behind Breastcancer.org.

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