Capecitabine with chemotherapy improves survival in breast cancer patients: Study

Germany: In a new study conducted by Marion T. van Mackelenbergh and the team it was found that when used in conjunction with systemic therapy, capecitabine improved overall survival (OS) and disease-free survival (DFS) in patients with triple-negative breast cancer (TNBC) and all patients with early breast cancer (EBC). The findings of this study were published in the European Journal of Cancer.

Despite the vast number of patients with early breast cancer who have received capecitabine in randomized trials, there was no individual patient data where meta-analysis has been carried out. The primary goal of this study was to look at the effect of capecitabine on disease-free survival, with secondary goals of looking at distant disease-free survival, pathological complete response (for neoadjuvant studies), and overall survival, and the interaction of capecitabine-related toxicity and treatment effect.

The following criteria were used to search clinicaltrials.gov and pubmed.ncbi.nlm.nih.gov for this study: use of capecitabine for EBC as adjuvant or neoadjuvant treatment; multicenter randomized trial with >100 patients; recruitment completed, and results accessible. For 13 trials, the necessary data were provided.

The key findings of this study are as follows:

1. Individual information from 15,993 patients was gathered.

2. Cox regression analysis of all patients included found that the addition of capecitabine had no meaningful effect on disease-free survival when compared to therapy without capecitabine.

3. In the subset of studies when capecitabine was used instead of another medication, there was no effect on disease-free survival.

4. However, adding capecitabine to the conventional systemic therapy enhanced disease-free survival.

5. The overall cohort and the capecitabine-added subset both saw an improvement in overall survival.

6. In terms of disease-free survival and overall survival, subgroup analysis demonstrated that triple-negative breast cancer patients benefited from capecitabine therapy both overall and in combination with other systemic therapies.

In conclusion, this study points out the efficiency of Capecitabine in disease-free survival and overall survival and should be regularly advised by physicians to their patients.

Reference: van Mackelenbergh, M. T., Seither, F., Möbus, V., O'Shaughnessy, J., Martin, M., Joensuu, H., Untch, M., Nitz, U., Steger, G. G., Miralles, J. J., Barrios, C. H. Effects of capecitabine as part of neo-/adjuvant chemotherapy – A meta-analysis of individual breast cancer patient data from 13 randomised trials including 15,993 patients. In European Journal of Cancer (Vol. 166, pp. 185–201). Elsevier BV. https://doi.org/10.1016/j.ejca.2022.02.003