Metronomic capecitabine as extended adjuvant chemotherapy in women with triple negative breast cancer

PURPOSE: High interest in triple-negative breast cancers is not surprising as this category of patients benefits neither from hormonal therapies nor from anti HER2 treatments. Blockade of angiogenesis by metronomic chemotherapy as well as other antiangiogenics might improve outcomes in this group of patients. This study aims to evaluate the tolerability and efficacy of metronomic capecitabine as extended adjuvant treatment for women with triple-negative breast cancer. Methods: This is a prospective phase II study that included 41 patients diagnosed with triple-negative breast cancer and who were indicated for adjuvant chemotherapy. They received capecitabine 500 mg PO twice daily and continuously for six months after finishing six cycles of adjuvant FEC100 +/- postoperative radiotherapy. Results: Forty-one patients were enrolled in this study between June 2010 and December 2013. Median age was 50 years ranging from 27 to 67 years. Treatment was well tolerated. Adverse effects were grade 1 palmar– plantar erythrodysesthesia in 13 patients [31.7%]; grade 1 diarrhea in five patients [12.2%]; and grade 1 vomiting in two patients [4.9%]. Estimated median follow-up duration was 34 months. Estimated mean disease-free survival [DFS] was 42.4 months [95% CI, 39.02–45.79], while median DFS was not reached. Estimated mean overall survival was 44.34 months [95% CI 41.9–46.9]. Conclusion: Extended adjuvant metronomic capecitabine is well tolerated with patient compliance. These results need to be compared in a study with control arm, larger sample, as well as longer follow-up