Clinical Impact of Metronomic Oral Combination Chemotherapy with Capecitabine and Cyclophosphamide in Patients with Metastatic Breast Cancer

FUJIHARA Miwa, YOSHIMURA Yuri, KAJIWARA Yukiko, ITO Mitsuya, OHTANI Shoichiro

doi:10.3919/jjsa.78.239

Capecitabine (X) and cyclophosphamide (C) can be administered orally and have synergistic effects with non-overlapping toxicities in patients with metastatic breast cancer (MBC). We administered XC therapy to heavily pretreated patients with MBC with excellent efficacy and minimal toxicity. A retrospective review was conducted of 67 patients with human epidermal growth factor receptor (HER) 2-negative MBC treated with XC therapy. The overall response rate was 41.8%. The median progression-free survival (PFS) was 9.2 months, and median overall survival (OS) was 31.5 months. The median PFS was 22.2 months in patients who suffered from hand-foot syndrome (HFS), but was 8.3 months in patients without HFS (p = 0.0003). HFS could be used as a prognostic factor. After disease progression (PD) was observed with administration of X (n = 7), additional administration of XC was effective (Response rate RR = 28.6%). After PD was observed with paclitaxel + bevacizumab (n = 12), XC was effective (RR = 33.3%). Grade 3 or 4 leukopenia was observed in 17.9%, and neutropenia was observed in 14.9% of patients. HFS was observed in 7.5% of patients, although no cases of grade 4 HFS occurred. Only two patients with grade 2 and 3 hemorrhagic cystitis interrupted therapy. XC therapy may be a promising oral chemotherapy that maintains good quality of life and is preferable for patients with MBC.

Clinical Impact of Metronomic Oral Combination Chemotherapy with Capecitabine and Cyclophosphamide in Patients with Metastatic Breast Cancer

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