Capecitabine monotherapy is associated with a clinical benefit rate (CBR) of 60% and a median time to progression (TTP) of 4 months in patients ≥65 years (yrs) with MBC. However, 30% require a dose reduction (DR) due to toxicity. At the Royal Marsden Hospital, the starting dose and schedule for capecitabine is 2000mg/m2 on days 1-14, every 3 weeks. Older patients (pts), with a poor performance status (PS), comorbidities and/or moderate to severe renal impairment may start with a further DR. If early CTCAE grade ≥2 toxicity occurs, a switch from 3-weekly to a week-on-week-off (WOWO) schedule is used to improve tolerance.
To evaluate toxicity and efficacy of capecitabine monotherapy in pts ≥70 yrs diagnosed with MBC. Primary endpoint- toxicity. Secondary endpoints- CBR, TTP & Overall Survival (OS).
From October 2013-October 2015, 77pts ≥70yrs retrospectively identified from the RMH Pharmacy Data Base received capecitabine monotherapy for MBC. Capecitabine was 1st line therapy in 65 pts (84%), with 43 & 34 receiving 2000mg/m2 &
In patients aged 70 years or older, capecitabine monotherapy at a starting dose of 2000mg/m2 or lower is associated with a median TTP of 8.2 months and a CBR of 43-67%. Toxicity can be managed by dose reductions and switching to a WOWO schedule, which enables continued treatment in those deriving clinical benefit.
Clinical trial identification
Legal entity responsible for the study
The Royal Marsden Hospital Clinical Research and Development Department
The Royal Marsden Hospital, London.
All authors have declared no conflicts of interest.