Results from a study recently published in Cancer indicate that capecitabine is an effective and well-tolerated treatment for patients with advanced breast cancer that has progressed after taxane and/or anthracycline-based therapy. Additionally, because it is administered orally, capecitabine significantly improves quality of life for patients during treatment compared to intravenously administered chemotherapy.
When a woman is first diagnosed with advanced breast cancer, her treatment usually consists of chemotherapy agents that are either taxane-based (paclitaxel or Taxotere®), anthracycline-based (Ellence™ or doxorubicin) or a combination of these. Unfortunately, the cancer cells that survive following treatment with these agents usually develop resistance and are no longer responsive to subsequent treatment with them.
Approximately 50% of all women diagnosed with breast cancer will develop metastatic cancer (cancer that spreads to distant locations in the body, such as the liver, lungs, bones or other sites). Once a patient with metastatic breast cancer becomes resistant to taxane or anthracycline chemotherapy, treatment options are limited and efforts are most often aimed at alleviating symptoms and prolonging survival, without intent to cure.
Capecitabine is a new chemotherapy agent that is unrelated to taxanes or anthracyclines. Numerous studies have demonstrated its efficacy in treating various cancers resistant to prior chemotherapy regimens. In addition, capecitabine is delivered orally, which significantly reduces medical costs and intrusive hospitalizations for patients and may even allow patients to receive treatment at home.
Recently, a multi-center clinical trial was conducted to evaluate capecitabine in 74 patients with recurrent breast cancer. All patients had received prior therapy with a taxane and 96% had also been previously treated with anthracycline-based chemotherapy.
The overall anti-cancer response rate following treatment with capecitabine was 26%. Women previously treated with paclitaxel and Taxotere® displayed response rates of 27% and 20%, respectively. On average, patients survived 12.2 months following treatment with capecitabine, with the cancer responding to treatment for an average of 8.3 months. Patients also experienced a significant drop in cancer-related pain and thus, substantially reduced their consumption of pain medication. Side effects were mild to moderate in intensity and consisted of skin loss on the hands and feet (hand-foot syndrome), diarrhea, nausea, vomiting and stomatitis (inflammation or ulcers of the oral cavity).
The results of this clinical trial suggest that capecitabine is effective and well tolerated by women with recurrent breast cancer resistant to treatment with taxanes and/or anthracyclines. In addition, the oral administration of capecitabine is preferred by patients, representing a significant advance for patient-oriented therapy that focuses on quality of life. Individuals with recurrent breast cancer previously treated with taxanes and/or anthracyclines may wish to speak with their physician regarding the risks and benefits of capecitabine or about participating in a clinical trial. Two sources of information regarding ongoing clinical trials include comprehensive, easy-to-use listing services provided by the National Cancer Institute (cancer.gov) and www.eCancerTrials.com. eCancerTrials.com also provides personalized clinical trial searches on behalf of patients. (Cancer, Vol 92, No 7, pp 1759-1768, 2001)