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Solo Capecitabine Shows Good Results in Advanced Breast Cancer: Presented at ICACT

By Jill Stein

PARIS, FRANCE -- February 6, 2007 -- Capecitabine is an appropriate first-line monochemotherapy for slowly progressing metastatic breast cancer (MBC), researchers reported here at the 18^th International Congress on Anti-Cancer Treatment (ICACT).

Alexandra Trainaud, MD, staff oncologist, Institut Bergonie, Bordeaux, France, and associates reviewed results obtained at their institution over a recent 4-year period with first-line capecitabine monotherapy in 167 women with MBC.

The primary treatment goals in slowly progressing MBC are long progression-free survival, minimal toxicity, and preservation of quality of life, Dr. Trainaud said in her presentation on February 6^th.

Capecitabine is an attractive monotherapy in this setting and offers high activity, good tolerability with no alopecia and little myelosuppression, and convenient oral administration that avoids frequent hospital or clinical visits, she said.

Many trials have evaluated capecitabine in pretreated MBC and, until recently, data on first-line capecitabine monotherapy have been limited, she continued. A phase 3 trial in this setting reported in December 2006 demonstrated a significant survival benefit with capecitabine versus conventional cyclophosphamide, methotrexate, and fluorouracil.

To be eligible for the present analysis, prior hormonal treatment for MBC was permitted but not prior chemotherapy for MBC.

Most patients were hormone-sensitive and had shown a long-lasting response to hormonal therapy prior to capecitabine. The median interval from diagnosis of MBC to initiation of capecitabine was 8 months. The median age at the initiation of capecitabine was 68 years.

An improvement in disease was seen in 56% of patients, and an additional 21% of patients had stabilization of their disease for a median of 5.5 months.

Median time to treatment failure was 9.0 months, and median overall survival was 5.8 months.

First-line capecitabine monotherapy did not compromise the ability to administer further treatment. Among the 94 patients who received further chemotherapy, 80 (85%) received a taxane, 38 (40%) received anthracycline, and 35 (37%) received vinorelbine.

Capecitabine was well tolerated and the safety profile was consistent with prior clinical trials of capecitabine monotherapy.

"Single-agent capecitabine is an active first-line chemotherapy for patients with slowly progressing MBC, offering convenient oral therapy with minimal toxicity and no alopecia," Dr. Trainaud observed. "In the absence of a consensus on treatment in this population, we consider capecitabine to be an appropriate treatment choice."


[Presentation title: First-Line Capecitabine Monotherapy for Metastatic Breast Cancer: High Efficacy Regardless of Prior Adjuvant Therapy. Abstract 195]

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