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Oral Capecitabine Active, Effective In Previously Treated Metastatic Breast Cancer

Patients with metastatic breast cancer who relapse following high-dose chemotherapy and autologous stem cell support may benefit from oral capecitabine.

The compound has proved an active and well tolerated first-line therapy for these patients, say American doctors.

According to researchers at the University of California in San Diego, high complete remission rates have been achieved with high-dose chemotherapy and autologous stem cell support in patients with metastatic breast cancer. However, they established that the majority undergoing this treatment will relapse within three years.

Since these patients may not be able to tolerate further myelosuppressive chemotherapy, and the ideal treatment is undefined, the researchers assessed the role of capecitabine as an initial therapy following relapse.

Participants included 10 patients, median age 47 years, whose disease progressed at a median of 246 days (range 69-480) following high dose chemotherapy with autologous stem cell support. Four were oestrogen receptor- positive, six had visceral disease. Prior anthracyclines was identified in eight and prior taxanes in 10.

Oral capecitabine 2,500mg/mē daily for two weeks was prescribed for two weeks of a three-week cycle as initial therapy for relapse. The patients were then assessed retrospectively for response and toxicity. They received a median total of eight cycles (range four to 24) of capecitabine.

Toxicities encountered during the capecitabine therapy included hand-foot syndrome in three patients with grade 1, four in grade 2, and one patient in grade 3. One patient at grade 1 and three in grade 2 had diarrhea, two were nauseous and five suffered fatigue but only one patient was identified as having haematological toxicity. Furthermore, hospitalization was not required by any patients for toxicity.

Three patients achieved complete remission, four had a partial remission and the disease was stabilized in three patients. At median follow-up of 183 days from commencing capecitabine (range 97-540) all patients were alive, and five were in remission. Five showed progress following remissions lasting between 63 and 252 days.
Clinical Oncology Vol 13 No 6 pp 434-437. "Use of Capecitabine as First-Line Therapy in Patients with Metastatic Breast Cancer Relapsing After High-Dose Chemotherapy and Autologous Stem Cell Support"

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