Source: DGNews  |  Posted 4 years ago

By Shazia Qureshi

PARIS, FRANCE -- February 8, 2008 -- Whether capecitabine treatment is given before vinorelbine treatment or vice versa does not appear to affect the efficacy of this combination therapy in metastatic breast cancer, according to research reported here at the 19th International Congress on Anti-Cancer Treatment (ICACT).

Lead author Mariana Steiner, MD, Head of the Oncology Department, Carmel Hospital, Haifa, Israel presented the findings of this study in a poster on February 7.

Capecitabine and vinorelbine are commonly used treatments in patients with metastatic breast cancer that does not respond to anthracycline and taxane treatment. Therefore, Dr. Steiner and colleagues conducted their study to determine whether the sequence of administration -- capecitabine first followed by vinorelbine or vice versa -- would have an effect on outcome in these patients.

Survival was slightly higher in patients who received capecitabine before vinorelbine but that this might be because of the study design rather than differences in efficacy, Dr. Steiner noted.

The study included 47 patients with metastatic breast carcinoma who had received prior treatment with anthracyclines and taxanes.

The dose of capecitabine used in the study was 2500 mg/m² over 2 divided doses on days 1 to 14 every 3 weeks. Vinorelbine was given to patients either alone at a dose of 30 mg/m² weekly or at a dose of 25 mg/m² combined with 5-fluorouracil 500 mg/m² and leucovorin 200 mg/m² on days 1 and 8 every 3 weeks.

The decision as to the order or administration was left up to the oncologist and the patient.

Capecitabine was administered first in 27 patients (group 1) and 20 patients were treated with the reverse sequence (group 2), Dr. Steiner reported. One difference between the 2 groups was the proportion of patients with visceral metastases: 59% of group 1 and 90% of group 2.

When capecitabine was used first, the overall response rates was 59%; when vinorelbine was used first, it was 60%. Both groups of patients had a median progression-free survival of 6 months. Median survival was 25 months in group 1 and 21.5 months in group 2.

When used second, both drugs were associated with a 30% overall response rate. Patients Median progression-free survival times in these two group were also similar, at 3.5 and 4 months in the capecitabine-second and vinorelbine-second groups, respectively.

According to these findings, there appears to be no reason to prefer one sequence over another when capecitabine and vinorelbine are both part of the treatment schedule, Dr. Steiner concluded.

[Presentation title: Capecitabine Followed by Vinorelbine or the Reverse Sequence in Metastatic Breast Carcinoma. Abstract PO 43]