CapeOX Protocol for BSA 1.8 m²

Detailed Dosing

• The National Comprehensive Cancer Network recommends a dose of 130 mg/m² of oxaliplatin for a patient with BSA 1.8 m², with a total dose of 234 mg, administered as an IV infusion over 2 hours on day 1, repeated every 3 weeks 1, 2
• The National Comprehensive Cancer Network recommends a dose of 1000 mg/m² of capecitabine twice daily for 14 days, with a total dose of 1800 mg twice daily for a patient with BSA 1.8 m², administered orally, repeated every 3 weeks 1, 2, 3, 4

Important Considerations

• North American patients may experience greater toxicity with capecitabine than European patients, with a recommended starting dose of 1000 mg/m² twice daily 3, 4, 1
• Close monitoring during the first cycle is essential, with dose adjustments as needed based on toxicity 4

Duration of Therapy

• The National Comprehensive Cancer Network recommends discontinuation of oxaliplatin after 3-4 months of therapy, or sooner if significant neurotoxicity ≥ grade 2 develops, with other drugs maintained until disease progression 3, 5
• Oxaliplatin may be reintroduced if it was discontinued previously for neurotoxicity rather than disease progression 3

Potential Modifications

• For significant neurotoxicity (≥ grade 2), consider oxaliplatin dose reduction or discontinuation 3
• If adding bevacizumab, administer 7.5 mg/kg IV on day 1 of each cycle, with an increased risk of stroke and other arterial events, especially in patients ≥65 years 1, 2, 3, 6

Monitoring Recommendations

• The National Comprehensive Cancer Network recommends CT scan with contrast or MRI to monitor progress of therapy, with regular assessment of neurotoxicity 6, 5, 3

Common Pitfalls to Avoid

• Do not use PET/CT to monitor progress of therapy; CT with contrast or MRI is recommended 6, 5
• Do not continue oxaliplatin beyond 3-4 months if significant neurotoxicity develops 3, 5
• Avoid combination therapy involving cytotoxics, anti-EGFRs, and anti-VEGFs 6, 5