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Xeloda in metastatic CRC: introduction

Xeloda in metastatic CRC: introduction. David Kerr University of Oxford Oxford, UK. Treatment landscape in MCRC: historically based on 5-FU. Meta-analysis of nine clinical trials: 5-FU/LV vs 5-FU alone ↑ response rates with 5-FU/LV (23 vs 11%) 1 no difference in overall survival 1

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Xeloda in metastatic CRC: introduction

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  1. Xeloda in metastatic CRC: introduction David Kerr University of OxfordOxford, UK

  2. Treatment landscape in MCRC: historically based on 5-FU • Meta-analysis of nine clinical trials: 5-FU/LV vs 5-FU alone • ↑response rates with 5-FU/LV (23 vs 11%)1 • no difference in overall survival1 • Continuous infusion (CI) vs bolus i.v. administration • response rate with CI ≈30% vs ≈10% with bolus 5-FU/LV2–4 • ↑ TTP with CI5 • no improvement in overall survival • Monthly vs weekly bolus 5-FU/LV (Roswell Park vs Mayo Clinic) • no difference in efficacy: response rate, 35 vs 31%; median overall survival, 9.3 vs 10.7 months • 1Advanced Colorectal Cancer Meta-Analysis Project. J Clin Oncol 1992;10:896–903 • 2Lokich JJ et al. J Clin Oncol 1989;7:425–32 • 3de Gramont et al. J Clin Oncol 1997;15:808–15 • 4Meta-Analysis Group in Cancer. J Clin Oncol 1998;16:301–8 • 5Köhne CH et al. J Clin Oncol 2003;21:3721–8

  3. 12 10 8 6 4 2 0 5-FU Bolus 5-FU/LV Infused 5-FU/LV Xeloda IFL FOLFOX FOLFIRI XELOX XELIRI IFL-Avastin XELOX-Avastin 1980s 2005 TTP in MCRC has increased with different therapies over time Median TTP (%)

  4. What are the current needs forthe treatment of MCRC? • Improve TTP and overall survival • Simplify complex combinations • chemotherapy combinations ± biologicals and/or small molecules • Effective, well tolerated regimens that are also convenient and cost effective • Address patients’ desire for effective chemotherapy that does not diminish quality of life

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