Dose modification does not compromise efficacy and enhances tolerability
Monotherapy
No dose adjustment is necessary for NCIC grade 1 toxicities. Higher grades of toxicity require dose modification to 75% or 50% of the Xeloda© standard starting dose of 1250 mg/m2 twice daily.
If a patient experiences grade 2 or higher severe toxicities that are considered likely to become life threatening, the dose of Xeloda© monotherapy should be reduced according to the dose modification scheme shown below.
| First appearance |
Interrupt treatment until resolved to grade 0/1, then continue at same dose with prophylaxis where possible |
Interrupt treatment until resolved to grade 0/1, then continue at 75% of original dose with prophylaxis where possible |
Discontinue treatment unless physician considers it to be in the best interests of the patient to continue at 50% of original dose once toxicity has resolved to grade 0/1 |
| Second appearance of same toxicity |
Interrupt treatment until resolved to grade 0/1, then continue at 75% of original dose |
Interrupt treatment until resolved to grade 0/1, then continue at 50% of original dose |
|
| Third appearance of same toxicity; |
Interrupt treatment until resolved to grade 0/1, then continue at 50% of original dose |
Discontinue treatment |
|
| Fourth appearance of same toxicity |
Discontinue treatment |
|
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| Xeloda© monotherapy dose modification scheme. From Van Cutsem et al.,1 with permission. | Xeloda© monotherapy dose modification scheme. From Van Cutsem et al.,1 with permission. |