Standard Chemo Found Superior to Capecitabine

Relapse, death twice as likely among older women with breast cancer in capecitabine group

18 may 2009-- Standard adjuvant chemotherapy was superior to capecitabine for treating older women with early breast cancer, though with substantial toxicity, according to research published in the May 14 issue of the New England Journal of Medicine.

Hyman B. Muss, M.D., of the University of Vermont in Burlington, and colleagues analyzed data from 633 women, ages 65 years and older, with early-stage cancer. Patients were randomized to receive capecitabine or standard chemotherapy, which consisted of cyclophosphamide, methotrexate, and fluorouracil or cyclophosphamide and doxorubicin.

After median follow-up of 2.4 years, capecitabine was associated with a higher risk of disease recurrence or death, which was the primary measure of efficacy (hazard ratio, 2.09). Patients in this group were twice as likely to have a relapse and nearly twice as likely to die. However, moderate to severe toxic effects were twice as common in the standard chemotherapy group (64 versus 33 percent).

"For the treatment of older patients, the choice of chemotherapeutic agents, dose, schedule, and dose modification should be based on the treatment plans in published reports. Our data are part of a developing body of evidence that the choice of adjuvant chemotherapy really matters in older women with breast cancer and that standard chemotherapy is superior to the oral agent capecitabine," the authors conclude.

The study was supported in part by Roche Biomedical Laboratories. Several co-authors disclosed financial relationships with Hoffmann-La Roche.

Abstract
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