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Question

4.A 59-year-old man is receiving capecitabine (1,500 mg orally twice daily, 2 weeks on, 1 week off) as adjuvant chemotherapy for his high-risk stage II colon cancer (T4,N0,M0, microsatellite stable). Ten days after the first dose of capecitabine, he is admitted for severe nausea/vomiting, mucositis, diarrhea, acute kidney injury (AKI), and coronary vasospasm. He is not dihydropyrimidine dehydrogenase deficient. His son is telling you that he wanted to defeat cancer to the last cell. With that aim in mind, he was taking capecitabine at 3,000 mg orally twice daily on three time weekly. In the next few days, his clinical situation is deteriorating. Your fellow is seeking for an antidote. Which of the following agents has shown efficacy in this setting?

A. IV leucovorin

B. Dexrazoxane (Zinecard)

C. Uridine triacetate

D. Glucarpidase

E. Anti-fluoropyrimidine antibody