Seven-Day On-Off Capecitabine Cycle Treats Breast Cancer

Modest efficacy and minimal toxicity for seven-day on-off capecitabine combined with bevacizumab

TUESDAY, March 22 (HealthDay News) -- Treatment of metastatic breast cancer (MBC) with capecitabine administered for seven days followed by seven days of rest in combination with bevacizumab has modest efficacy and minimal toxicity, as predicted previously by mathematical modeling, according to a study published online March 8 in Cancer.

Devika Gajria, M.D., M.P.H., from the Memorial Sloan-Kettering Cancer Center in New York City, and colleagues evaluated the mathematical predictions for optimal dosing and scheduling of capecitabine in combination with bevacizumab for the efficient treatment of MBC with minimal toxicity. A total of 41 women with measurable MBC were treated with 2000 mg of oral capecitabine twice daily for seven days, followed by a seven-day rest period, and 10 mg/kg of intravenous bevacizumab every two weeks. The study end point was response rate. Toxicity, clinical benefit rate, and progression-free survival (PFS) were also measured.

The investigators observed partial responses in 20 percent of the patients after an average of seven months. The average PFS was eight months, and stable disease for six months or more was seen in 35 percent of the patients. Treatment toxicities that were frequently reported included hand-foot syndrome, hypertension, and fatigue. Gastrointestinal side effects, including diarrhea, nausea, and vomiting, were uncommon.

"We believe that capecitabine administered for seven days followed by a seven-day rest has demonstrated efficacy worthy of further study and that it may offer a favorable toxicity profile with respect to gastrointestinal side effects," the authors write.

The study was partially funded by Roche Laboratories Inc. and Genentech.

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