Eloxatin (oxaliplatin)
Eloxatin (oxaliplatin) is given as combination chemotherapy for colon or rectal cancer.
- FOLFOX or FLOX with 5-fluorouracil plus leucovorin
- XELOX (also known as CAPOX): with the oral pill Xeloda® (capecitabine)
- Avastin® (bevacizumab) can be added to FOLFOX or CAPOX to treat stage IV or recurrent colorectal cancer
When Eloxatin is used
- Stage II or III rectal cancer in the FOLFOX or XELOX regimen simultaneously with radiation treatments as a continuous infusion, either before surgery to shrink a rectal tumor or after surgery to help prevent recurrence in the rectum itself.
- High-risk stage II colon cancer to prevent recurrence after surgery.
- Stage III colon cancer to prevent recurrence after surgery.
- Stage IV or recurrent (metastatic) cancer of the colon or rectum to increase survival time, reduce tumors to permit potentially curative surgery, or prevent recurrence after surgery for metastatic tumors.
Common side effects from oxaliplatin
Neuropathies
Acute reactions to cold. In the first days after oxaliplatin treatment, patients may have sharp, sudden reactions to cold, particularly in the face, throat, hands and feet. Eating or drinking anything cold can cause numbness or sharp pain around your mouth or in your throat. Some people describe this as “taking your breath away,” but actual breathing isn’t usually affected. The best way to avoid or ease these symptoms, is take the following precautions, especially in the first 5 days after treatment:
- Avoid going outside in the cold, or cover your mouth/nose with a scarf.
- Avoid touching cold objects. Don’t wash your hands in cold water. If necessary, use gloves to get food out of a freezer or refrigerator.
- Wear socks to keep your feet warm.
- Be aware of air conditioning, and avoid intense air-conditioning.
- Don’t eat anything colder than room temperature for at least 5 days after a treatment.
Rare breathing reaction: About 1 in 100 people get a less common, more immediate type of neuropathy that appears as a dry cough, or sensation of difficulty breathing, swallowing, or speaking.
Stay calm. The feeling is temporary and will go away. This may happen during an infusion, or soon afterward. Again, cold exposure makes it more severe. Try sipping a warm drink and holding your hands over your mouth to warm the air you’re breathing, and notify your doctor or nurse.
Peripheral neuropathy. As exposure to oxaliplatin increases, patients begin to experience tingling, pins and needles, and numbness in their hands and feet. It may become painful or difficult to use your hands, especially for small-motor tasks like buttoning a shirt or picking things up. In severe cases, balance or walking is affected.
Peripheral neuropathy gets better for most patients after treatment ends. At the end of a year or 18 months, only a few people will continue to have symptoms. Symptoms may continue to get worse for a few weeks after treatment before beginning to fade.
Peripheral neuropathy can managed by reducing the amount of oxaliplatin patients receive. Stop-and-go treatment strategies such as OPTIMOX optimize the use of oxaliplatin while not reducing its effectiveness. Studies have found that infusions of calcium and magnesium before and after the oxaliplatin infusion can also reduce both acute and peripheral neuropathy. Clinical trials of other agents are underway to prevent or reduce oxaliplatin-caused neuropathy.
If you experience neuropathy, you need to take special care not to hurt yourself if you cannot feel tools that are sharp, hot water, steps or flooring, or other dangerous situations.
Other Eloxatin side effects
Decreased bone marrow function: Eloxatin can temporarily interfere with your bone marrow’s ability to make new blood cells, possibly causing:
- decreased white blood cells (neutropenia) and increased risk of infection. Call your doctor or nurse if you have a fever, redness, swelling, pain when urinating or other sign of infection.
- fewer red blood cells (anemia), with tiredness or shortness of breath.
- decreased platelets (thrombocytopenia) with slower blood clotting resulting in easy bruising or bleeding.
Mild diarrhea: Call your doctor if vomiting or diarrhea lasts more than 24 hours, if you have vomiting or cramping, or you have signs of dehydration such as dizziness, dry mouth, or less urine.
How oxaliplatin is given:
Oxaliplatin (Eloxatin®) is given as an infusion into a vein.
Last Update: June 24, 2008
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