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EOX

Find out about what EOX is, how you have it and other important information about having EOX.

EOX is the name of a chemotherapy combination. It includes the drugs:

  • E – epirubicin
  • O – oxaliplatin
  • C – capecitabine (Xeloda)

It is treatment for:

  • gastro oesophageal cancer – the junction of the stomach and oesophagus
  • oesophageal cancer
  • stomach cancer

How EOX works

These chemotherapy drugs destroy quickly dividing cells, such as cancer cells.

How you have EOX

You have:

  • capecitabine as a tablet - you take it twice a day, morning and night, swallow it whole with plenty of water, speak to your pharmacist if you have problems swallowing the tablets
  • epirubicin as an injection into your bloodstream (intravenously) once each cycle
  • oxaliplatin as a drip into your bloodstream over 2 hours once each cycle

Into your bloodstream

You have oxaliplatin and epirubicin into your bloodstream. You can have these drugs through a thin short tube (a cannula) that goes into a vein in your arm each time you have treatment.

Or you might have them through a long line: a central line, a PICC line or a portacath. These are long plastic tubes that give the drug into a large vein in your chest. The tube stays in place throughout the course of treatment.

Taking your tablets

You must take tablets according to the instructions your doctor or pharmacist gives you

Whether you have a full or empty stomach can affect how much of a drug gets into your bloodstream.

You should take the right dose, not more or less.

Never stop taking a cancer drug without talking to your specialist first.

When you have it

You have EOX chemotherapy as cycles of treatment each lasting 3 weeks. Depending on your needs, you may have up to 8 cycles, taking around 6 months in total.

You have each cycle of treatment in the following way:

Day 1
  • epirubicin as an injection into your vein
  • oxaliplatin as a drip for 2 hours into the bloodstream
  • take capecitabine tablet morning and evening
Day 2 to Day 21
  • take capecitabine tablets morning and evening

Tests during treatment

You have blood tests before starting treatment and during your treatment. They check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.

Side effects

Important information

Other medicines, foods and drink

Cancer drugs can interact with some other medicines and herbal products. Tell your doctor or pharmacist about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies.

Pregnancy and contraception

This treatment might harm a baby developing in the womb. It is important not to become pregnant or father a child while you are having treatment and for a few months afterwards. Talk to your doctor or nurse about effective contraception before starting treatment.

Fertility

You may not be able to become pregnant or father a child after treatment with these drugs. Talk to your doctor before starting treatment if you think you may want to have a baby in the future. Men may be able to store sperm before starting treatment. Women may be able to store eggs or ovarian tissue but this is rare.

Breastfeeding

Don’t breastfeed during this treatment because the drugs may come through in your breast milk.

DPD deficiency

Around 5 out of 100 people (5%) have low levels of an enzyme called DPD in their bodies. A lack of DPD can mean you’re more likely to have severe side effects from capecitabine. It doesn’t cause symptoms so you won’t know if you have a deficiency. Contact your doctor if your side effects are severe.

Treatment for other conditions

Always tell other doctors, nurses or dentists that you’re having this treatment if you need treatment for anything else, including teeth problems.

Immunisations

Don’t have immunisations with live vaccines while you’re having treatment and for at least 6 months afterwards.

In the UK, live vaccines include rubella, mumps, measles, BCG, yellow fever and Zostavax (shingles vaccine).

You can:

  • have other vaccines, but they might not give you as much protection as usual
  • have the flu vaccine
  • be in contact with other people who've had live vaccines as injections

Avoid contact with people who’ve had live vaccines taken by mouth (oral vaccines). This includes the rotavirus vaccine given to babies. The virus is in the baby’s urine for up to 2 weeks and can make you ill. So, you mustn't change their nappies for 2 weeks after their vaccination.

You also need to avoid anyone who has had oral polio or typhoid vaccination recently.

More information about this treatment

For further information about this treatment go to the electronic Medicines Compendium (eMC) website.

You can report any side effect you have to the Medicines Health and Regulatory Authority (MHRA) as part of their Yellow Card Scheme.

Information and help

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