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Xeloda and 5FU

pepebcn's picture
pepebcn
Posts: 6352
Joined: Aug 2010

l see many of you have Xeloda as maintenance or treatment even after folfox or folfiri failed ( which are the most powerful drugs right now!) As per l know Xeloda is basically fluoracil so ,is there anybody who can explain me the difference between them? well l see one...pills vs 3 days infusion
is that all or there are other reasons?
Hugs!

taraHK
Posts: 1961
Joined: Aug 2003

I guess the main reason for doing xeloda rather than 5FU as a maintainence drug is the convenience of the pill rather than the 48 (+!) hour drip.

I think the effectiveness is pretty similar (last time I checked the research).

The side effects are different too -- xeloda has the disadvantage of hand/foot syndrome (appears to affect some people worse than others). I guess other side effects are pretty individual. For me, when I was on 5FU I had a lot of trouble with white blood cell counts. This seems much less of an issue for xeloda (I've never had chemo postponed for low WBC -- happened a lot while I was on 5FU). But I'm not sure if others have found that too.....

TAra

maglets's picture
maglets
Posts: 2589
Joined: Jun 2006

I had tons of weird skin reactions to 5fu....headaches skin swelling and peeling off.

Far fewer side effects with xeloda...I had a lot of abdominal pains on xeloda but not so much of the skin stuff. Also i had a problem getting xeloda covered by insurance. Any chemo in the hospital was covered but because the pills were taken at home the insurance would not cover them.

This rule probably varies greatly from place to place but something to ask about for sure.

mags

pepebcn's picture
pepebcn
Posts: 6352
Joined: Aug 2010

Seems are very similar but not the same, .Mags, did you had Xeloda Before or after Folfox? l suppose that was the combo they put you with 5FU! Actually what lm trying to understand is if it can be a new way in case my folfiri Fails( l already had folfox last year and it worked perfect but now in this recurrence changed to folfiri don't understand why?).
Thks mags.

maglets's picture
maglets
Posts: 2589
Joined: Jun 2006

sorry I really was not clear.

first after the initial colon surgery I was on 5FU
next after mets to liver I had the liver resection and then 8 months of xeloda all alone

2 years later the liver mets were back and I did infusions of oxy combined with the xeloda pills...

pepebcn's picture
pepebcn
Posts: 6352
Joined: Aug 2010

much clear now! are you still on chemo?
Best to you!

snommintj's picture
snommintj
Posts: 602
Joined: Mar 2009

There is evidence that xeloda is a few percentage points more effective than 5FU. Here is the reason. 5fu mimics one of our DNA bases. While our DNA replicates nucleotides (AGCT) form long chains. 5FU is substituted for the T. As the DNA replicates, proteins come along and check for any out of place nucleotides. They see that the T isn't there and they fix it. Eventually the cell runs out of the necessary protein for repairing the DNA. When the cell recognizes that it can't properly replicate itself. It kills itself, known as apoptosis or programmed cell death. Over time our cells realize that they need to make more proteins for DNA repair. When the cell begins to make enough protein, cells are then desensitized to the 5FU mechanism.

Xeloda is a metabolic induced delivery of 5FU. Our cells ingest xeloda. As our cells metabolize it, one of the byproducts is 5FU. The method of cell death is then identical regular 5FU. Xeloda seems to deliver a smaller dose over a much longer time frame and because it is metabolized. It is slightly more effective on cells that metabolize very quickly (cancer).

pepebcn's picture
pepebcn
Posts: 6352
Joined: Aug 2010

Thankyou for that!
Very helpful !

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