xeloda and blood brain barrier

[Ceesun]

I know I asked about this before and received several responses....but what evidence is there out there that xeloda crosses the blood brain barrier? Does it do it on its own or in combination with other drugs? thanks. I am wondering if those of us on Xeloda have that protection. Ceesun

[heblaj01]

Ceesun,

Acording to info on the web, Xeloda like the parent drug fluorouracil (into which Xeloda is converted in the body) crosses the BBB & has the potential to protect the brain. (http://cpharm.vetmed.vt.edu/VM9096/handout.htm )

However the Phase 3 clinical trial of the Xeloda+Tykerb combo resulted in much better brain protection than Xeloda alone as published in june 2006.
Out of 160 patients on the combo only 4 had brain mets while 16 got mets among the 160 on Xeloda alone

[Barbara2]

I had 5-fu (flourouracil) along with Cytoxan and Epirubicin as part of my original chemo treatment. I asked my onc if 5-fu crosses the blood-brain barrier, and he said it didn't.

I'm hoping your information is correct; that it does cross the BBB.

[pattyz]

Ceesun,

I know of gals who developed brain mets while on a course of Xeloda.

Xeloda alone showed a good response for a gal whom my onc treats for bc brain mets. Her OTHER mets progressed, however.

Xeloda is technically small enough, molecular wgt wise, to cross the bbb. There is also the 'leaky bbb' to consider, caused by rads, tumors themselves and ???

Xeloda is being used as a trial drug with other drugs for brain mets. Why would they use it if they didn't believe it did indeed have the potential to cross the bbb?

In my own case, I've been using it in conjunction with Temodar, fairly successfully for the past 18 months to control my current 8 brain mets.

I know, more info that you were looking for, and I apologize for that.

This will most likely be a case where YOUR answer lies somewhere in the 'every one is different' catagory.....

best wishes to you,
pattyz

[hannah]

Hi

my sister has been on xeloda since last Dec having previously had WBR, Gamma Knife and tax for brain mets. Has had them for nearly 3 yrs, last Oct her condition deteriorated, falling over, dizzy, nausea and vomiting we thought she had come to the end of the road. New scans in July showed NED in lungs and liver and best of all significant shrinkage of brain mets so hope this answers your question. I did go with my sis with all info on Patty Z and how well it had worked for her so good luck.
Hannah

[heblaj01]

While Xeloda can help treat brain cancer it also sometimes causes non cancerous brain diseases as reported in anecdotic cases by PUBMED.

When Xeloda does not help other treatments are available, among them Temodar already mentioned .
Also worth mentioning is this experimental treatment successfully tried in Germany on a single patient who failed to lastingly respond to various drug regimens : Herceptin injected in the spine to reach the brain in spite of the blood brain barrier which prevents intravenous Herceptin to cross it.

http://patient.cancerconsultants.com/news.aspx?id=36779

[al from Canada]

Just remember that in a HER2 BC, the combination of herceptin + chemo is expodentially better than either one alone. That said, even if xeloda does cross the BBB, it is likely to be of little benefit if not combined with a HER2 blocker that crosses the BBB, ie, tykerb. Linda was on xeloda for over one year and still developed brain mets.

Al