Efficacy of Very-Low-Dose Capecitabine in Metastatic Breast Cancer.
| Autor: | Bertelsen, Caitlin, Lingyun Ji, Garcia, Agustin A., Russell, Christy, Spicer, Darcy, Sposto, Richard, Tripathy, Debu |
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| Předmět: |
BREAST cancer prognosis
THERAPEUTIC use of antimetabolites ACADEMIC medical centers ANTIMETABOLITES BREAST tumors CANCER chemotherapy CANCER patients COMPARATIVE studies CONFIDENCE intervals DOSE-effect relationship in pharmacology DRUG toxicity LONGITUDINAL method METASTASIS SURVIVAL analysis (Biometry) DRUG approval TREATMENT effectiveness RETROSPECTIVE studies DESCRIPTIVE statistics EVALUATION |
| Zdroj: | American Journal of Hematology/Oncology; Feb2015, Vol. 11 Issue 2, p20-30, 11p |
| Abstrakt: | Background: The FDA-approved dosage of capecitabine, 1250 mg/m2 twice daily, is often associated with treat-ment-limiting toxicities. Clinical experience and published reports suggest that lower starting dosages of capecitabine can be as effective as the approved dosage. In this retrospective analysis we compared the efficacy of significantly lower dosages of capecitabine with the FDA-approved dosage, using previously published results as comparators. Patients and Methods: We performed a retrospective cohort analysis of patients treated at University of Southern California hospitals who received capecitabine as the first, second, or third line of chemotherapy for metastatic or unresectable locally advanced breast cancer to determine the progression-free survival (PFS) associated with low starting dosages. Results: Patients (n = 84) received a median capecitabine dosage of 565 mg/m² twice daily, mostly administered as a flat dosage (not adjusted for body surface area) of 1000 mg twice daily.The median PFS among patients with measurable disease (n = 62; 74% of patients) was 4.1 months (95% confidence interval, 2.9-5.7), which was similar to the median PFS values (4.4 months; 4.2 months) for sin-gle-agent capecitabine reported in the 2 major trials with similar eligibility criteria. Furthermore, only 2 patients (2.4%) discontinued capecitabine due to toxicity, supporting our hypothesis that starting treatment at low dosages minimizes side effects while preserving efficacy. Conclusions: Our results provide evidence that very low dosages of capecitabine are efficacious in treating metastatic breast cancer. Large-scale randomized, controlled trials testing lower starting dosages of capecitabine are necessary in order to firmly establish an optimally effective and well-tolerated dosage. [ABSTRACT FROM AUTHOR] |
| Databáze: | Complementary Index |
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