capecitabine + oxaliplatin + fruquintinib + sintilimab

This combination consists of capecitabine, oxaliplatin, fruquintinib, and sintilimab. Capecitabine and oxaliplatin are a well-established chemotherapy combination known as CAPOX or XELOX, used primarily for colorectal cancer, as well as cancers of the food pipe (esophagus) and stomach. This combination works by destroying quickly dividing cells, such as cancer cells. Fruquintinib is an anti-vascular endothelial growth factor (VEGF) 1/2/3 inhibitor, while sintilimab is an anti-programmed death-1 (PD-1) antibody. This combination (fruquintinib plus sintilimab) has shown promising efficacy in various cancers including metastatic colorectal cancer (mCRC) and clear cell renal cell carcinoma (ccRCC). The provided information does not specifically mention all four drugs being used together as a single regimen, but rather shows evidence of the two separate combinations (CAPOX and fruquintinib+sintilimab) being studied for similar indications, particularly colorectal cancer. **Administration and Dosing** For CAPOX/XELOX: * Oxaliplatin is administered intravenously (130 mg/m² on day 1 of a 21-day cycle) * Capecitabine is taken orally as tablets (typically 1000 mg/m² twice daily for days 1-14 of a 21-day cycle) For fruquintinib plus sintilimab: * Fruquintinib 5 mg once daily, 2 weeks on/1 week off * Sintilimab 200 mg every 3 weeks **Clinical Evidence** The CAPOX/XELOX combination has been extensively studied and is a standard treatment for colorectal cancer. A phase I study established its recommended dosing schedule. Fruquintinib plus sintilimab has shown promising efficacy in clinical trials: * In metastatic colorectal cancer, this combination demonstrated an objective response rate of 23.8% and median progression-free survival of 6.9 months * In advanced clear cell renal cell carcinoma, treatment-naive patients showed a 68.2% objective response rate, while previously treated patients had a 60.0% response rate **Side Effects** Common side effects for CAPOX/XELOX include: * Gastrointestinal issues (nausea, vomiting, diarrhea) * Neurological effects (dysesthesia, paresthesia) * Hematological abnormalities (lymphocytopenia, thrombocytopenia, neutropenia) For fruquintinib plus sintilimab, common treatment-related adverse events include: * Proteinuria * Hypothyroidism * Hypercholesterolemia * Hypertriglyceridemia * Hypoalbuminemia **Special Considerations** Before starting treatment with capecitabine, patients should have a blood test to check for gene changes affecting DPD (dihydropyrimidine dehydrogenase) enzyme levels, as DPD deficiency increases the risk of serious side effects from capecitabine. For elderly or frail patients with colorectal cancer, reduced-intensity CAPOX chemotherapy has shown similar efficacy with less toxicity and better overall treatment utility.

Other names

XELOX + fruquintinib + sintilimabFISSION regimenXELOX-F-S