Capecitabine First-Line Option in Advanced Breast Cancer Therapy

Similar activity, less toxic, more tolerable than cyclophosphamide, methotrexate, and fluorouracil

TUESDAY, Oct. 25 (HealthDay News) -- Capecitabine is a good first-line treatment alternative to cyclophosphamide, methotrexate, and fluorouracil (CMF) for some women with advanced breast cancer, according to a study published online Oct. 24 in the Journal of Clinical Oncology.

Martin R. Stockler, M.B.B.S., from the University of Sydney in Australia, and colleagues investigated whether treatment with oral capecitabine was preferable to CMF as first-line chemotherapy for 323 women with advanced breast cancer who were unsuited for more intensive chemotherapy. Participants were randomized to receive intermittent capecitabine for 14 of every 21 days, continuous capecitabine for 21 of every 21 days, or CMF. Quality-adjusted progression-free survival (PFS), PFS, overall survival, objective tumor response, and adverse events were assessed. When intermittent and continuous capecitabine were similar, they were combined for definitive comparison with CMF.

The investigators found that women assigned to capecitabine and CMF had similar quality-adjusted PFS (P = 0.2), objective tumor response rate (20 percent; P = 0.8), and PFS (median, six months; hazard ratio, 0.86; 95 percent confidence interval, 0.67 to 1.10; P = 0.2). Women treated with capecitabine had longer overall survival than those treated with CMF (22 versus 18 months). Hand-food syndrome was more common with capecitabine treatment, whereas febrile neutropenia, infection, stomatitis, and serious adverse events were more common with CMF.

"Capecitabine is a good first-line chemotherapy option for women with advanced breast cancer who are unsuited to more intensive regimens," the authors write.

Several authors disclosed financial relationships with pharmaceutical companies, including Roche, which partially funded the study and manufactures capecitabine.

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