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Clinical efficacy of capecitabine as first-line chemotherapy in metastatic breast cancer



Clinical efficacy of capecitabine as first-line chemotherapy in metastatic breast cancer



Journal of Clinical Oncology 24(18_Suppl): 10727-10727



NlmCategory="UNASSIGNED">10727 Background: Capecitabine is commonly used in metastatic breast cancer (MBC), but there are limited data on its efficacy in the first-line setting. The clinical efficacy of capecitabine monotherapy was evaluated in our institution. Patients who received capecitabine monotherapy (starting dose 1 g/m2 twice daily every 2 out of 3 weeks) between April 2001 and April 2005 as first-line treatment for advanced disease were retrospectively identified from our prospectively maintained database. Endpoints included response rate (RR), response duration, time to progression (TTP) and overall survival (OS). 63 patients were evaluated. The median age was 57 (30-79) years. The sites of disease were soft tissue and/or bone only in 24 (38%) patients, and involved visceral sites in 39 (62%) patients. 45 (71%) patients had previously received adjuvant or neoadjuvant chemotherapy. The median number of cycles administered was 5 (1-40). 48 (76%) had measurable disease with a RR of 29% (14/48). Chemotherapy-naive patients with measurable disease had a RR of 33% (5/15), while patients previously exposed to neoadjuvant or adjuvant chemotherapy had a RR of 27% (9/33). The median response duration was 24(9-68) weeks. The median TTP was 18 (range 2-122) weeks. However 12(19%) had a TTP of 9 months or more, including 7 (11%) with a TTP of >1 year (14-28 months). Of these, 6/7 were oestrogen receptor +ve and 5/7 had bone and/or soft tissue disease only. 21 (33%) patients developed disease progression on treatment, and response was not evaluable in 4 (6%) patients who stopped capecitabine after 2 or fewer cycles due to medical co-morbidities. These audit results on first line capecitabine monotherapy in MBC are consistent with a previously published study(1). The overall RR may be less than for anthracyclines and taxanes (generally 30-50%) in this setting, but for a subgroup of patients with predominantly soft tissue/bone disease capecitabine can result in prolonged TTP with minimal toxicity. This should be evaluated further in a randomized clinical trial. References 1. O'Shaughnessey JA et al. Ann Oncol 2001 Sept; 12 (9): 1247-54. [Table: see text].

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Accession: 057421762

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PMID: 27954981


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