Abstract 4772
Background
Adjuvant capecitabine (adjC) is recommended for patients with triple-negative breast cancer (TNBC) and poor response to neoadjuvant chemotherapy. Despite evidence of benefit, this therapy is not available in situations of limited resources, such as in the Brazilian public health system.
Methods
A retrospective observational cohort study was conducted in Princess Margaret (PM) Cancer Centre in Toronto, Canada, and in A.C.Camargo Cancer Center (AC) in São Paulo, Brazil. Patients with TNBC who had completed neoadjuvant chemotherapy (taxane and/or anthracycline) followed by surgery, with a high residual cancer burden (RCB-II or RCB-III) and received at least 1 cycle of adjC in PM or had active surveillance (AS) in AC were evaluated. A descriptive comparison was made between PM and AC. Recurrence free survival (RFS), overall survival (OS), and safety profile were explored descriptively. Chi-Square test and Mann-Whitney test were used to assess categorical and continuous variables data, while Kaplan-Meier survival and Cox-regression were used for time-to-event analyses.
Results
From 06/17 to 03/19, 21 patients received adjC in PM and from 04/02 to 03/19, 70 patients had AS in AC. Starting dose of capecitabine was 1000 mg/m² bid. Seven patients (43.8%) completed 8 cycles, two (12.5%) received 6 cycles and for the remaining patients therapy is ongoing. The median follow-up was 23 months (range 1.9-36 months). At PM 76.2% of the patients were free from recurrence or death and 81% were alive at 3 years. The mean RFS was better in the adjC group (mean 30.8 months vs 20.0 months HR: 0.23; p = 0.045). Mean OS was 29 months in adjC group vs 28 months in AS (HR: 1.48; p = 0.610). Common adverse events were hand-foot syndrome, fatigue, diarrhea, nausea and anemia. Dose reduction, delay to next chemotherapy cycle or discontinuance of treatment were necessary in 13 (61.9%) patients.
Conclusions
Outcome of patients receiving adjC at PM was better than those on AS in AC, suggesting benefit from this treatment in a real-world setting. AdjC is an inexpensive, widely available and well tolerated oral chemotherapy and should be considered an option for improvement of care even in public health systems of less developed countries.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
This work has been supported by a UICC Technical Fellowship.
Disclosure
E. Amir: Speaker Bureau / Expert testimony: Genentech/Roche; Advisory / Consultancy: Apobiologix; Advisory / Consultancy: Agendia; Advisory / Consultancy: Myriad Genetics. All other authors have declared no conflicts of interest.
Resources from the same session
2104 - Clinical implications of regorafenib-induced hypothyroidism in metastatic colorectal cancer refractory to standard therapies: A prospective evaluation
Presenter: Jwa Hoon Kim
Session: Poster Display session 2
Resources:
Abstract
2143 - Clinical impact of BRAF V600E mutations in patients (pts) with resectable solitary colorectal liver metastases (CRLM)
Presenter: Shin Kobayashi
Session: Poster Display session 2
Resources:
Abstract
3136 - Trifluridine/tipiracil in metastatic colorectal cancer: an updated multicentre real-world analysis on efficacy, safety and predictive factors.
Presenter: Chara Stavraka
Session: Poster Display session 2
Resources:
Abstract
4234 - Correlation between p53 expression and clinical outcome in RAS/BRAF wild type metastatic colorectal cancer patients receiving later-line irinotecan-cetuximab
Presenter: Eleonora Lai
Session: Poster Display session 2
Resources:
Abstract
4287 - Safety and effectiveness of aflibercept + FOLFIRI for the treatment of patients with metastatic colorectal cancer (mCRC): OZONE secondary analyses
Presenter: Ian Chau
Session: Poster Display session 2
Resources:
Abstract
1820 - A Phase Ib study of the safety and efficacy of atezolizumab (atezo) + bevacizumab (bev) + cobimetinib (cobi) in patients (pts) with metastatic colorectal cancer (mCRC)
Presenter: Johanna Bendell
Session: Poster Display session 2
Resources:
Abstract
5644 - Development and validation of a metastasis-associated immune prognostic model for concurrent metastatic colorectal cancer
Presenter: Zhiwen Luo
Session: Poster Display session 2
Resources:
Abstract
5697 - Prognostic role of blood cell count-based immuno-inflammatory parameters in the Valentino trial
Presenter: Giovanni Fuca
Session: Poster Display session 2
Resources:
Abstract
4704 - Evaluation of safety, immunogenicity and preliminary efficacy of PolyPEPI1018 vaccine in subjects with metastatic colorectal cancer (mCRC) with a predictive biomarker
Presenter: Joleen Hubbard
Session: Poster Display session 2
Resources:
Abstract
3266 - Morphology of tumor-associated macrophages dictates the prognosis of patients with colorectal liver metastases.
Presenter: Matteo Donadon
Session: Poster Display session 2
Resources:
Abstract