eTNBC: add-on adjuvant capecitabine extends survival in meta-analysis

  • Li Y & al.
  • Breast Cancer Res Treat
  • 21 Dec 2019

  • curated by Miriam Davis, PhD
  • Univadis Clinical Summaries
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Takeaway

  • Adjuvant capecitabine added on to taxane-/anthracycline-based standard chemotherapy improves DFS and OS in a meta-analysis of 7 trials of early (e) triple-negative breast cancer (TNBC).

Why this matters

  • TNBC poses the greatest risk to survival given its high metastatic and recurrence rates relative to other breast cancer subtypes.
  • Individual trials of add-on adjuvant capecitabine have displayed conflicting results.
  • This meta-analysis is the first of its kind.

Study design

  • A meta-analysis of 7 randomized controlled trials, including 1599 patients receiving capecitabine in the adjuvant setting.
  • Funding: Fundamental Research Funds for the Central Universities, China.

Key results

  • The capecitabine group had a 23% improvement in DFS (pooled HR, 0.77; 95% CI, 0.66-0.90):
    • Subgroup analysis by region found improved DFS in:
      • America-Europe trials: pooled HR, 0.813 (95% CI, 0.676-0.976); and
      • Asia trials: pooled HR, 0.666 (95% CI, 0.491-0.902).
    • Subgroup analysis found improved DFS in trials involving 6-8 cycles of add-on capecitabine (pooled HR, 0.710; 95% CI, 0.588-0.857) but not 4 cycles (pooled HR, 0.928; 95% CI, 0.699-1.232).
  • The capecitabine group, in 6 trials, had a 31% improvement in OS (pooled HR, 0.69; 95% CI, 0.56-0.85).

Limitations

  • Heterogeneity across studies.