Capecitabine(Xeloda) dose change

[DinNorCal]

I have been on Capecitabine for about 9 months at a dose of 2000 mg per day (2 weeks on 1 week off). My scans have shown good results with the last scan showing no progression.

My question is, has anyone had experience with reducing dose to 2000 mg 1 week on then 1 week off? My Dr. Has suggested changing because of my fatigue level. I am concerned it will not work as well. My Dr. Has reported cases of it working as well as 2 weeks on 1 week off.

I had been on endocrine therapy since being diagnosed in early 2017. Capecitabine is my first chemo treatment.

I am ER + Her2- with tumors in spine only.

Any comments appreciated.

[Hazelgreen]

I think you should be very grateful that your oncologist cares about your level of fatique. Why not try the reduced schedule for a couple of cycles and have another scan? It is certainly easy to increase your meds if there is any growth of cancer cells.

[DinNorCal in reply to Hazelgreen]

I am thankful that my Oncologist listens to me. I plan to try the new schedule. Thanks for your reply.

[bubblystream in reply to Hazelgreen]

hmmmm

They reduced Ibrance and Piqray for me. It still worked. They reduced Taxol and it quit working right away. I know because my hair started to grow in. Scans 3 months later showed progression in the liver. But bone Mets are easy to treat and respond as been my experience. It’s the liver Mets that are “testy”.

[Kerryd22]

When a drug is trialled the researchers are trying to find the maximum tolerable dosage as well as effectiveness etc but there’s plenty of evidence that a lower dose is just as effective as the maximum dose. Some drugs are being used in different schedules as well as at different dosage rates. I’d take the oncologist up on his advice myself because the less side affects the better in my book. He wouldn’t have raised the possibility if he didn’t think it would be okay. The dosage can always be returned to the maximum if a scan identifies an unwelcome change.

[DinNorCal in reply to Kerryd22]

Thanks for your insight. I was on Ibrance and Faslodex for over 2 years, changing to 75 mg a few months in. I will make this change and see how it works. Always good to hear responses from fellow warriors.

Take care.

[Bettybuckets]

many patient are doing well on one week on one week off… my DFCI doctor told me about her mother in law that stayed on Cape successfully for 8 years…. She said it works exquisitely well for lobular which I have. I am in the one week on one week off 2000mg schedule. It working well X 6 months. Good luck!

[DinNorCal in reply to Bettybuckets]

Hoping and praying the best for both of us on this journey and this medication.

How wonderful it worked for 8 years.

[Fiercefighter13]

Hi there! I’m lobular ER/PR positive and Xeloda is working really well for me. I’m on one week on, one week off. Looking to lower dose once my markers are at normal. I’m 4 months my markers have gone from 586 to 48. Hope this helps! Take care!

[DinNorCal in reply to Fiercefighter13]

That’s terrific news on your markers. 😀

Hope you can soon lower your dose.

[Bettybuckets in reply to Fiercefighter13]

Wow! Mine were 459 and have dropped to 150 and that is great! Now that I feel better I do so much more and sometimes my feet are so sore… how about you? I lowered my dose to 2000 mg every other week… for now.

[Fiercefighter13 in reply to Bettybuckets]

My feet hurt a lot, they are red and sting. My hands are the same way. I also have terrible fatigue. My doctor started me Ritalin for the fatigue and Cymbalta for the hand and foot pain, they have helped tremendously and I’m feeling better now.

[Bettybuckets in reply to Fiercefighter13]

Hi FF- I was doing great on the new lowered dose- but then I soaked in a HOT TUB! What was I thinking?!! It has taken me days ti get over the hot sore feet thst made my feet so sore. Don’t forget adn do that! But I went in a mineral hot pool in nz for 3 evenings in a row and I felt like that helped my feet.. but that was a natural geothermal place and this was a backyard hot tub with chemicals.. prob big difference. My hands are not a problem for me… except for the tips a bit sore.. I credit celebrex a Cox 2 inhibitor which helps.. might help me manage with much less fatigue basically none… compared to Ibrance and Verzenio any way. And I got sketcher sandals which an are squishy and very loose… I had to give up sneakers even when I bought 1.5 size bigger. Feet too sore when I stuffed them in. And I should soak more in Epsom salt that helps. Oh and the one thing I do religiously is each night I slather in 40 % urea cream and then I put on Gel socks.. last nights left them on all night… better in the morning. I don’t use white cotton socks cuz the cream absorbs into the sock and my foot is dry. Does that make sense?

[Fiercefighter13 in reply to Bettybuckets]

Makes sense!! I can’t use NSAIDS or Cox 2 inhibitors because my cancer is in my stomach causing ulcers, which is challenging for managing pain. I do use urea cream though and things are manageable at the moment. Thank goodness for Xeloda in spite of its side effects! Thank you for sharing tips for managing the hand/foot!! I’m in Disneyland for 5 days and my feet are not happy, but managing with it! Take care!!

[PJBinMI]

Your current dose and schedule are what Iwas started on earlier this year. My hands, especially finger tips, became painfully sensitive so my onc reduced it to 1500 mg per day week on, week off. Just as effective but hands still red, sensitive, though not as much, so now I am on 1000 per day, 7 days on, seven days off. I'm currently on day 4 of 7 days off, second cycle of this dose. hands not back to normal but alot better! I'm a long timer (19 years+ !) and have made a point of learning all I can about BC, MBC, treatment, have attended multiple conferences, advocate training, and was able to sit on a committee reviewing potential new meds and recommending which ones to move forward in the process. I agree with what others have said here! Finding the lowest effective dose of our treatment drugs often helps our quality of life. I hope this new schedule works well for you!

[DinNorCal]

Thank you for sharing your experience and your knowledge. It is reassuring.

Is your 19 years with Metastatic Breast Cancer, or are you including years with an original BC diagnosis?

I hope your side effects decrease and wish you the best 🙏🏻