Capecitabine in Elderly Patients with Metastatic Breast Cancer

• Published in: Tumori 2012-05, Vol.98 (3), p.303-307
• Main Authors: De Sanctis, Rita, Quadrini, Silvia, Longo, Flavia, Lapadula, Vittoria, Restuccia, Rossella, Del Signore, Ester, De Filippis, Lucilla, Stumbo, Luciano, Gori, Bruno, Bianco, Vincenzo, Speranza, Iolanda, Basile, Maria Luisa, Di Seri, Marisa
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Antimetabolites, Antineoplastic - administration & dosage; Antimetabolites, Antineoplastic - adverse effects; Antimetabolites, Antineoplastic - therapeutic use; Antineoplastic Agents, Hormonal - therapeutic use; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Breast Neoplasms - drug therapy; Breast Neoplasms - mortality; Breast Neoplasms - pathology; Capecitabine; Chemotherapy, Adjuvant; Deoxycytidine - administration & dosage; Deoxycytidine - adverse effects; Deoxycytidine - analogs & derivatives; Deoxycytidine - therapeutic use; Diarrhea - chemically induced; Disease-Free Survival; Drug Administration Schedule; Female; Fluorouracil - administration & dosage; Fluorouracil - adverse effects; Fluorouracil - analogs & derivatives; Fluorouracil - therapeutic use; Hand-Foot Syndrome - etiology; Humans; Kaplan-Meier Estimate; Mucositis - chemically induced; Neoplasm Staging; Quality of Life; Retrospective Studies; Treatment Outcome
• ISSN: 0300-8916; 2038-2529
• DOI: 10.1177/030089161209800304

Aims and background Capecitabine is the reference treatment for anthracycline-and/or taxane-pretreated metastatic breast cancer (MBC). This study examined its efficacy, tolerability and impact on the quality of life of elderly patients with MBC. Materials and methods Between January 2002 and December 2009, 75 consecutive elderly patients with MBC received first-line chemotherapy with capecitabine 1000 mg/m2 twice daily for 14 days every 3 weeks. Endpoints were efficacy, tolerability and clinical-benefit response measured every 3 cycles. Results Median age was 76 years (range 65–88); median ECOG performance status was 1 (range 0–2); 51 patients (68%) had received adjuvant chemotherapy and all patients had received hormonal therapy. Median exposure was 6 cycles. After 3 cycles, 11 patients (14.7%) had a partial response, one patient experienced a complete response, and 49 patients (65.3%) had stable disease, amounting to a disease control rate of 81.3%. Stable disease was maintained in 45 patients (60%) after 6 cycles, in 21 patients (28%) after 9 cycles, and in 13 patients (17.3%) after 12 cycles. A clinical-benefit response was experienced by 42 patients (56%), indicating a positive impact on quality of life. Treatment was well tolerated, the most common grade 3 events being diarrhea (12%) hand-foot syndrome (8%), and mucositis (8%). Adverse events were managed with dose adjustments and supportive therapy when required. Conclusions Our results indicate that capecitabine is active and well tolerated in elderly patients with MBC. This dosing regimen warrants further study in the first-line setting for patients with less aggressive MBC who are not candidates for combination therapy.