Topic: All about Xeloda

Forum: Stage IV/Metastatic Breast Cancer ONLY — Please respect that this forum is for members with stage IV/metastatic breast cancer ONLY. There is a separate forum for caregivers and friends: Caring for Someone with Stage IV or Mets.

Posted on: Jul 25, 2011 07:08AM

Posted on: Jul 25, 2011 07:08AM

Lynn1 wrote:

I will complete my first cycle of Xeloda today (2 weeks on; one week off).  I have already noticed some signs of HFS on my feet.  Sometimes they are red and feel hot.  I've had some minor skin peeling, but not any blistering.  The heels are the worst (the most sensitive) and it is uncomfortable to walk.  I hope I get to see the onc today too so I'm going to show him and ask what to do.  At least it's my last day so I will get a week off, but I'm worried about what will happen when I start again.  I'm hoping he will agree to lower the dose -- even just a little might help.  What do you think?  Also, what should I do now that it's already started?  Thanks in advance!!

~Lynn ER+, HER2- Bone mets: sternum, pelvis, spine, ribs....it's everywhere. Started Afinitor/Femara 10/15/12
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Jan 21, 2023 09:17AM lizo1 wrote:

nkb - I think about Lynn often as she and my wife Liz started Xeloda about the same time. I also worry when people disappear from discussions.

I reached out to Lynn and I hope to get a response.

Grant.

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Jan 21, 2023 02:45PM - edited Jan 21, 2023 02:45PM by divinemrsm

denny, thanks for the heads up about folic acid and Xeloda! I will check on it.



found lump 12-22-10—ilc—er+/pr+/her2—stage iv bone mets—chemo~lumpectomy~radiation~arimidex—March 2019-ibrance/aromasin* —Sept 2019-verzenio* —March 2020-xeloda*
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Jan 24, 2023 01:11PM divinemrsm wrote:

The results of my stress test came back good. No blockages of oxygen or blood to the heart, no irregular heartbeat, heart is pumping normally. I have an echocardiogram scheduled in two weeks which checks for other things. I am hoping for good results. I don’t feel like I have any heart issues, only went to the cardiologist due to high blood pressure and elevated pulse. I don’t have chest pain or shortness of breath. The bp medicine seems to be working well. But, we’ll see. I’m glad to be getting my heart checked out, tho.


found lump 12-22-10—ilc—er+/pr+/her2—stage iv bone mets—chemo~lumpectomy~radiation~arimidex—March 2019-ibrance/aromasin* —Sept 2019-verzenio* —March 2020-xeloda*
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Jan 24, 2023 05:15PM kbl wrote:

DivineMrsM, great news. I hope yourechocardiogram gives you the same good news.

De Novo ILC - No primary found. Mets to full spine, femurs, skull, and stomach. Missed diagnosis from 2013 to 2019 Dx 5/1/2019, ILC, Stage IV, metastasized to bone/other, ER+/PR+, HER2- Targeted Therapy 5/1/2019 Ibrance (palbociclib) Hormonal Therapy 5/1/2019 Faslodex (fulvestrant) Chemotherapy 9/27/2021 Xeloda (capecitabine) Hormonal Therapy Femara (letrozole)
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Jan 27, 2023 07:48PM bookgal wrote:

Has anyone seen a recent study or trial about a modified schedule of initial dosing to lessen these types of side effects like mouth sores? I've had progression & I am now on a crash course of learning about my treatment options before I meet with my MO in a couple days. Xeloda was mentioned before by my Onc. I have learned much skimming through these posts and other internet sites.. Has anyone heard of this?. I'd like to bring it to my onc but I can't find it anywhere and I am not sure where I read that. A bit of information overload! Does this study sound familiar to anyone? Perhaps it doesn't exist and was just my wishful thinking, lol!

What was your initial dosing like? Personally, Id like to start lower then move up. Not sure what to expect.

Also, I watched a video that mentioned the side effect of hot hands & feet in addition to HFS (doesn't sound fun) cold gloves and socks were mentioned. What are they? Are they socks that have little ice packs in them or are they a sock with gel or water beads. I iced my feet with chemos like Taxol but never had any fancy socks. Just ziploc baggies lol! Lotion on feet and hands seems more doable than icing.

I'll continue to learn from you smarties by reading through the posts. Thanks for any info given.

Dx 6/2013, IDC/DCIS/LCIS/ILC, Right, 6cm+, Stage IIIA, Grade 2, 10/13 nodes, ER+/PR+, HER2- Chemotherapy 8/25/2013 Cytoxan (cyclophosphamide), Ellence (epirubicin), Taxol (paclitaxel) Hormonal Therapy 6/1/2014 Femara (letrozole) Targeted Therapy 11/1/2019 Kisqali Hormonal Therapy 3/4/2020 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Hormonal Therapy 4/28/2022 Faslodex (fulvestrant) Dx ILC/IDC, Other, Stage IV, ER+/PR+, HER2-
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18 hours ago gonegirl wrote:

hey, all. I'm new to this forum because I'm getting to start Xeloda soon. Been reading through postings and getting lots of information. Btw, my oncologist gave advice to avoid hot foods and beverages to avoid mouth sores. Oy. I'm still going to have coffee but it'll be cooled. Sad

I appreciate seeing you all and getting good advice. Good to see you, divinemrsm, and that you're chugging along.

I haven't started yet, but I'm glad to fine you all.

Susan ( once gritgirl)

Targeted Therapy 2/9/2012 Herceptin (trastuzumab) Chemotherapy 2/9/2012 Taxol (paclitaxel) Surgery 11/1/2012 Mastectomy (Left): Simple; Mastectomy (Right): Simple; Reconstruction (Left): Silicone implant; Reconstruction (Right): Silicone implant Surgery 11/5/2012 Mastectomy; Mastectomy (Left); Mastectomy (Right); Reconstruction (Left); Reconstruction (Right) Targeted Therapy 12/7/2013 Kadcyla (T-DM1, ado-trastuzumab) Radiation Therapy 11/6/2015 External Local Metastases 11/6/2015 Radiation therapy: Bone Targeted Therapy 9/11/2018 Herceptin (trastuzumab) Targeted Therapy 9/11/2018 Perjeta (pertuzumab) Radiation Therapy 3/24/2022 Other part
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17 hours ago nkb wrote:

Bookgal and gonegirl- I am no longer taking Xeloda- but, noticed a difference in schedule based a bit on which coast you live on. East coast seems to use more 7/7 schedule and west coast more 14/7. dosage is based on weight usually if your kidney function is good. Although USC uses 2000mg per day regardless of weight. apparently since we have so much folic acid in our diets ( added to cereals etc) we can't tolerate as high a dose as the Europeans.

There are a few studies comparing 7/7 and 14/7 for GI cancers and one small one on breast cancer- but, most clinicians will tell you that studies have not been done. What I read was that the side effects really increase after day 8 and the anti-cancer effects decrease so that 7/7 is a sweet spot- but, I live on the west coast so started 14/7- only after begging and having low ANCs -so had to keep delaying the next cycle- was I able to switch to 7/7 -my MO had never done it and was not thrilled- worked great for a few years and I never had another abnormal lab and foot issues were only dry, scaly issues.

Others will chime in and give you their prospective- I found it an easy treatment - no mouth sores etc.

Dx 12/2011, ILC, Both breasts, 6cm+, Stage IIIC, Grade 2, 34/40 nodes, ER+/PR+, HER2- Surgery 2/4/2012 Lymph node removal; Lymph node removal (Left): Underarm/Axillary; Lymph node removal (Right): Underarm/Axillary; Mastectomy; Mastectomy (Left); Mastectomy (Right) Chemotherapy 2/28/2012 AC + T (Taxol) Radiation Therapy 9/11/2012 Hormonal Therapy 10/21/2012 Arimidex (anastrozole) Dx 5/2017, ILC, Stage IV, metastasized to bone, ER+/PR-, HER2- Hormonal Therapy 6/1/2017 Faslodex (fulvestrant) Targeted Therapy 6/1/2017 Ibrance (palbociclib) Targeted Therapy 3/13/2019 Afinitor (everolimus) Hormonal Therapy 3/13/2019 Aromasin (exemestane) Chemotherapy 3/10/2020 Xeloda (capecitabine) Targeted Therapy 9/13/2022 Enhertu (fam-trastuzumab deruxtecan-nxki)
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15 hours ago - edited 8 hours ago by weninwi

Xeloda dosage is based on body surface area. Height and weight are put into a formula to calculate a person's BSA body surface area. This is the calculator I used: https://www.calculator.net/body-surface-area-calcu...

My cancer facility uses the Mosteller formula. Whatever your m2 number is, that's the number that gets multiplied by Xeloda's dosing guidelines......1250mg/m2 or 1000mg/m2.

The FDA recently updated the prescribing information for Xeloda.

Source: https://www.empr.com/home/news/xeloda-labeling-upd...

"The recommended dosage of XELODA is 1,000 mg/m2 or 1,250 mg/m2 orally twice daily for the first 14 days of a 21-day cycle until disease progression or unacceptable toxicity. Individualize the dose and dosing schedule of XELODA based on patient risk factors and adverse reactions."

My MO prescribed my dose based on the 1,250mg/m2 option, but she told me she always lowers the dose or "rounds down". So I started on a smaller dose than if she had prescribed based on the new 1,000mg/m2 option. My concerns calmed down after I realized my dose was not at the high end.

I started on 1500mg 2x/day for 14 days on/7 days off.

My MO said she usually starts with the 14 on/7 off schedule. If side effects warrant then she may lower the dose to something like 1500mg AM 1000mg PM while keeping the 14 on/7 off schedule.....or she may keep the initial dose and go to the 7 on/7 off schedule. I got a second opinion from a Mayo MO and she told me she usually orders 7 on/7 off because patients have fewer side effects.

I'm in my 3rd cycle. My bothersome side effects so far are increase peripheral neuropathy (like walking on blocks of wood) and fatigue. I've not had hand/foot symptoms yet, but apply lotion liberally twice a day and have been using several different lotions per suggestions offered on this thread. I've had two small mouth sores that cleared up after using 1/2 tsp salt and 1/2 tsp baking soda in 8 oz water- rinse and spit 2-3x day - doesn't seem like much, but it worked for me. My labs have been OK except for RDW CV and RDW SD which are elevated. I assume this indicates the Xeloda is affecting my bone marrow. I've tweaked my diet to reduce folate intake and do not take a B complex supplement. My next labs and scans are Feb 6. I'm of course hopeful the Xeloda has halted the progression in my liver and bones that occurred while on Everolimus and Fulvestrant (got no benefit from this combo)....and that my labs are OK.

I need to add: After starting Xeloda, I was informed by an oncology pharmacist, that since it is an oral chemo, high dose Vit C and Zinc should be avoided, the same as for any chemo whatever the route. The amount of Vit C and zinc in a multi-vitamin or obtained in the diet is OK. This was new information for me as Xeloda is my first chemo.

Dx 7/2016, ILC, Left, 2cm, Stage IA, Grade 3, 0/1 nodes, ER+/PR+, HER2- Hormonal Therapy 11/1/2016 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Dx 6/2019, ILC, Other, Stage IV, metastasized to bone/liver, ER+/PR+, HER2- Hormonal Therapy 6/14/2019 Femara (letrozole) Targeted Therapy 7/4/2019 Verzenio Targeted Therapy 10/26/2021 Ibrance (palbociclib) Hormonal Therapy 9/13/2022 Faslodex (fulvestrant) Targeted Therapy 9/29/2022 Afinitor (everolimus) Chemotherapy 12/10/2022 Xeloda (capecitabine) Surgery Lumpectomy; Lumpectomy (Left); Lymph node removal Radiation Therapy Whole breast: Breast
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11 hours ago gonegirl wrote:

weninwi. I hope your scans go woo.

My oncologist is wanting to do 14 on 7 off. She's going to start me mid-level dose and report any side effects. Before this the cancer was in the t8 and t9 vertebrae and the t9 collapsed. I had to have back fusion surgery which was hard. I'm gonna pray this works and the side effects aren't bad. I've been in horrible painn for over a year. I can use a break. Nkb, so glad to hear it was easy for you

Susan

Targeted Therapy 2/9/2012 Herceptin (trastuzumab) Chemotherapy 2/9/2012 Taxol (paclitaxel) Surgery 11/1/2012 Mastectomy (Left): Simple; Mastectomy (Right): Simple; Reconstruction (Left): Silicone implant; Reconstruction (Right): Silicone implant Surgery 11/5/2012 Mastectomy; Mastectomy (Left); Mastectomy (Right); Reconstruction (Left); Reconstruction (Right) Targeted Therapy 12/7/2013 Kadcyla (T-DM1, ado-trastuzumab) Radiation Therapy 11/6/2015 External Local Metastases 11/6/2015 Radiation therapy: Bone Targeted Therapy 9/11/2018 Herceptin (trastuzumab) Targeted Therapy 9/11/2018 Perjeta (pertuzumab) Radiation Therapy 3/24/2022 Other part

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