398 - Long term use of capecitabine in patients with locally recurrent or metastatic breast cancer

Date 28 September 2012
Event ESMO Congress 2012
Session Publication Only
Topics Anti-Cancer Agents & Biologic Therapy
Breast Cancer, Metastatic
Presenter Debra Josephs
Authors D.H. Josephs1, R. Mir2, T. Siow3, L.E. Dumas3, V. Michalarea3, E. Sawyer2, J.L. Mansi3
  • 1Medical Oncology, Guys and St Thomas's NHS Trust, SE1 9RT - London/UK
  • 2Clinical Oncology, Guy's and St Thomas' NHS Trust, SE19RT - London/UK
  • 3Medical Oncology Offices, 4th Floor Bermondsey Wing, Guys Hospital, Guys and St Thomas's NHS Trust, SE1 9RT - London/UK

Abstract

Background

Capecitabine monotherapy is considered standard treatment in anthracycline- and taxane-pretreated locally recurrent or metastatic breast cancer and has proven efficacy in this setting. Here we report the findings of a retrospective study to evaluate the impact of continuing capecitabine treatment beyond the standard 6 cycles until disease progression, on efficacy and outcomes in patients with locally recurrent or metastatic breast cancer. In addition we sought to consolidate the information known about capecitabine dose modification and efficacy outcomes in this patient population.

Patients and methods

Clinical databases in two institutions were used to identify all patients with locally advanced or metastatic breast cancer treated with capecitabine over the period July 2006 – July 2011. Baseline characteristics, progression-free (PFS) and overall survival (OS) were recorded.

Results

In total, 150 patients met the inclusion criteria. Of these patients 67 (45%) received less than 6 cycles, 17 (11%) received 6 cycles only and 66 (44%) received more than 6 cycles of capecitabine. 65 (43%) patients commenced treatment at a dose less than 1250mg/m2 twice daily and 60 patients (40%) received a dose reduction during treatment. Median overall survival was longer in those patients who received more than 6 cycles of capecitabine treatment (20.9 months) compared to those who stopped at 6 cycles by clinical decision (16.3 months) although this did not reach significance (P = 0.088). PFS and OS were similar among patients who received lower vs. full-dose capecitabine (PFS P = 0.32, OS P = 0.71).

Conclusions

In this retrospective analysis, patients receiving more than 6 cycles of treatment had a better OS than those who stopped at 6 cycles (by clinical decision). Continuing capecitabine monotherapy beyond the standard 6 cycles if well tolerated, should be considered in patients with locally recurrent or metastatic breast cancer as this may prolong PFS. In addition, these data support the practice of dose-reducing capecitabine, including the possibility of starting at a lower dose (<1250 mg/m2 twice daily), to reduce the incidence of adverse events without compromising efficacy.

Disclosure

All authors have declared no conflicts of interest.