Does Extended Adjuvant Capecitabine Improve Survival in Triple-Negative Breast Cancer?
Posted: Tuesday, April 21, 2020
According to research published in the Journal of Clinical Oncology, extended adjuvant capecitabine does not result in survival benefits in patients with early triple-negative breast cancer who have undergone standard chemotherapy. However, according to Miguel Martín, MD, PhD, of the Spanish Breast Cancer Group in Madrid, and colleagues, a preplanned subset analysis revealed that patients with the nonbasal phenotype seemed to reap some benefit from capecitabine, but further validation of this finding is necessary.
Known as GEICAM-CIBOMA, the phase III study included 876 patients who were randomly assigned to receive either capecitabine (n = 448) or undergo observation (n = 428). At a median follow-up of 7.3 years, disease-free survival was comparable in both groups (hazard ratio = 0.82; 95% confidence interval, 0.63–1.06; P = .136). However, patients with nonbasal phenotypes did seem to experience some survival benefit when compared with those with basal phenotypes. The addition of capecitabine resulted in a disease-free survival hazard ratio of 0.53 versus 0.94 (P= .0694) and an overall survival hazard ratio of 0.42 versus 1.23 (P = .0052) in nonbasal versus basal subgroups, respectively. Overall, 75.2% of patients underwent all eight cycles of treatment, in line with tolerability expectations.
Patients eligible for this study had operable triple-negative breast cancer and had previously received chemotherapy containing anthracycline, taxane, or both. Participants were required to have node-positive disease unless they had node-negative disease with a tumor of at least 1 cm. The majority of patients had a basal phenotype (73.9%), underwent prior combination anthracycline/taxane treatment (67.5%), and/or had node-negative disease (55.9%). The median patient age was 49 years.
Disclosure: For full disclosures of the study authors, please visit ascopubs.org.