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Miami Breast Cancer Conference 2021: Tolerability of Capecitabine in U.S. Patients With Triple-Negative Breast Cancer

By: Julia Fiederlein
Posted: Monday, March 15, 2021

In the CREATE-X trial, capecitabine seemed to prolong overall survival in a predominantly Asian population of patients with triple-negative breast cancer. According to Alaina J. Kessler, MD, MPH, of the Mount Sinai Hospital, New York, and colleagues, capecitabine's toxicity may be higher in patients from the United States than those from East Asia. This retrospective review presented during the virtual edition of the 2021 PER’s Miami Breast Cancer Conference (Abstract 01) seemed to support this claim.

A total of 283 patients with residual disease after neoadjuvant chemotherapy were administered eight cycles of 1,250 mg/m2 of capecitabine in the CREATE-X trial. In this study, the investigators focused on 36 patients from a large academic medical center in New York City. Of this population, 33.3% were White, 27.8% were Black, and 5.6% were Asian. A total of 34 patients who were treated with 1,250 (n = 19) or 1,000 (n = 15) mg/m2 of capecitabine were included in the tolerance analysis.  

Compared with the U.S. cohort, more patients in the CREATE-X cohort completed eight cycles at the planned dose (37.8% vs. 0%). The rates of completed treatment with dose reduction were 36.7% and 31.6% in the CREATE-X and U.S. cohorts, respectively. The treatment discontinuation rate was 25.4% in the CREATE-X cohort and 31.6% in the U.S. cohort. A total of 20% of patients in the U.S. cohort tolerated eight cycles of 1,000 mg/m2 of capecitabine; of them, one patient required a dose reduction.

Hand-foot syndrome (68.4% vs. 60.0%) and nausea (47.4% vs. 33.3%) were reported more frequently with 1,250 mg/m2 than with 1,000 mg/m2 of capecitabine. However, this did not seem to hold true for diarrhea (26.3% vs. 33.3%, respectively).

Disclosure: No information regarding conflicts of interest was provided.

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