Clinical value and toxicities of docetaxel plus capecitabine in the first line treatment of metastatic breast cancer

Abstract

Abstract:ObjectiveTo evaluate the clinical value and toxicities of docetaxel plus capecitabine in the firstline treatment of metastatic breast cancer (MBC), and compare the outcomes among different molecular subtypes. MethodsA total of 108 patients with MBC who received docetaxel plus capecitabine combination treatment between January 1， 2012 and December 31， 2015 in Bejing Chaoyang District Sanhuan Cancer Hospital were retrospectively analyzed, and 104 cases were available for evaluation. The clinicopathological characteristics, clinical value and toxicities of these patients were evaluated. ResultsThe patients were divided into 3 molecular subtypes, among 104 patients, 85 patients in Luminal subtype, 14 patients in triple negative breast cancer (TNBC) subtype, and 5 patients in human epidermal growth factor receptor2 (HER2) over expression subtype. The treatment achieved objective responses (OR) in 55 patients (52.9%), and the disease control rate (DCR) was 88.5%, including complete response (CR) in 4 patients, partial response (PR) in 51 patients, stable disease (SD) in 37 patients, and progressive disease (PD) in 12 patients. In Luminal subtype, 4 patients achieved CR, 43 PR, 33 SD, and 5 PD. In TNBC subtype, 6 patients achieved PR, 3 SD, 5 PD. In the HER2 over expression subtype, 2 patients achieved PR, 1 SD, 2 PD. There was no significant difference in the shortterm therapeutic effect among 3 molecular subtypes (χ2=4.429, P=0.106). As a result, the progressionfree survival (PFS) of the 104 patients was 1.5121.0 months, and the median PFS was 10.0 months. The median PFS was 11.0 months in Luminal subtype, 4.0 months in TNBC subtype and 10.3 months in HER2 over expression subtype, with a significant difference (χ2=7.510, P=0.006). The most common adverse events were handfoot syndrome (HFS), nausea or vomiting, neutropenia, anaemia, diarrhea and so on. The incidence of grade 2/3 HFS was 44.2% (46/104), and the grade 3/4 neutropenia was 39.4% (41/104). ConclusionThe firstline treatment of MBC using docetaxel plus capecitabine is effective, and the toxicities can be tolerable, especially in the Luminal subtype.

Key words:Breast neoplasms,Neoplasm metastasis,Drug therapy,Molecular classification

Ou Kaiping, Ma Fei, Zhang Yurong, Liu Weili, Lyu Jianhong, Zhou Hua. Clinical value and toxicities of docetaxel plus capecitabine in the first line treatment of metastatic breast cancer[J]. Journal of International Oncology, 2017, 44(6): 423-.

References

［1］ Cardoso F, Senkuskonefka E, Fallowfield L, et al. Locally recurrent or metastatic breast cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and followup［J］. Ann Oncol, 2010, 22 Suppl 6 (suppl_5): 15-18. DOI: 10.1093/annonc/mdr372. ［2］ Hortobagyi GN, de la Garza Salazar J, Pritchard K, et al. The global breast cancer burden: variations in epidemiology and survival［J］. Clin Breast Cancer, 2005, 6(5): 391-401. ［3］ Sawada N, Ishikawa T, Fukase Y, et al. Induction of thymidine phosphorylase activity and enhancement of capecitabine efficacy by taxol/taxotere in human cancer xenografts［J］. Clin Cancer Res, 1998, 4(4): 1013-1019. ［4］ Bevers TB, Anderson BO, Bonaccio E, et al. NCCN clinical practice guidelines in oncology: breast cancer screening and diagnosis［J］. J Natl Compr Canc Netw, 2009, 7(10): 1060-1096. ［5］ Vici P, Giotta F, Di Lauro L, et al. A multicenter phase Ⅱ randomized trial of docetaxel/gemcitabine versus docetaxel/capecitabine as fistline treatment for advanced breast cancer: a Gruppo Oncologico Italia Meridionale study［J］. Oncology, 2011, 81(34): 230-236. DOI: 10.1159/000334432. ［6］ Soto C, Torrecillas L, Reyes S, et al. Capecitabine(X) and taxanes in patients with anthracyclinepretreated metastatic breast cancer (MBC): sequential vs. combined therapy results from a MOSG randomized phase Ⅲ trial［J］. Geophys Res Abstr, 2006 (18Suppl): 570. ［7］ O′shaughnessy J, Miles D, Vukelja S, et al. Superior survival with capecitabine plus docetaxel combination therapy in anthracyclinepretreated patients with advanced breast cancer: phase Ⅲ trial results［J］. J Clin Oncol, 2002, 20(12): 2812-2823. DOI: 10.1200/JCO.2002.09.002. ［8］ Perou CM, Sorlie T, Eisen MB, et al. Molecular portraits of human breast tumours［J］. Nature, 2000, 406(6797): 747-752. DOI: 10.1038/35021093. ［9］ Goldhirsch A, Wood WC, Coates AS, et al. Strategies for subtypesdealing with the diversity of breast cancer: highlights of the St. Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2011［J］. Ann Oncol, 2011, 22(8): 1736-1747. DOI: 10.1093/annonc/mdr304. ［10］ Surmeli ZG, Varol U, Cakar B, et al. Capecitabine maintenance therapy following docetaxel/capecitabine combination treatment in patients with metastatic breast cancer［J］. Oncol Lett, 2015, 10(4): 1352-1354. DOI: 10.3892/ol.2015.3546. ［11］ Hong JY, Park YH, Choi MK, et al. Characterization of durable responder for capecitabine monotherapy in patients with anthracycline and taxanepretreated metastatic breast cancer［J］. Clin Breast Cancer, 2015, 15(5): e287-e292. DOI: 10.1016/j.clbc.2015.04.004. ［12］ Martín M, Martínez N, Ramos M, et al. Standard versus continuous administration of capecitabine in metastatic breast cancer (GEICAM/200905): a randomized, noninferiority phase Ⅱ trial with a pharmacogenetic analysis［J］. Oncologist, 2015, 20(2): 111-112. DOI: 10.1634/theoncologist.20140379.

[1]	Wang Ying, Liu Nan, Guo Bing.Advances of antibody-drug conjugate in the therapy of metastatic breast cancer[J]. Journal of International Oncology, 2024, 51(6): 364-369.
[2]	Gao Fan, Wang Ping, Du Chao, Chu Yanliu.Research progress on intestinal flora and non-surgical treatment of the colorectal cancer[J]. Journal of International Oncology, 2024, 51(6): 376-381.
[3]	Sa Qiang, Xu Hangcheng, Wang Jiayu.Advances in immunotherapy for breast cancer[J]. Journal of International Oncology, 2024, 51(4): 227-234.
[4]	Yang Zhi, Lu Yiqiao, Gu Huayan, Ding Jialing, Guo Guilong.Research progress of tumor microenvironment mediated drug resistance in targeted therapy of breast cancer[J]. Journal of International Oncology, 2024, 51(4): 235-238.
[5]	Li Shuyue, Ma Chenying, Zhou Juying, Xu Xiaoting, Qin Songbing.Progress of radiotherapy in oligometastatic non-small cell lung cancer[J]. Journal of International Oncology, 2024, 51(3): 170-174.
[6]	Yue Hongyun, Zhang Baihong.Differentiation therapies in human cancers[J]. Journal of International Oncology, 2024, 51(2): 109-113.
[7]	Sun Guobao, Yang Qian, Zhuang Qingchun, Gao Binbin, Sun Xiaogang, Song Wei, Sha Dan.Research progress on the histopathological growth patterns of colorectal liver metastasis[J]. Journal of International Oncology, 2024, 51(2): 114-118.
[8]	Chen Boguang, Wang Sugui, Zhang Yongjie.Role of serum cholinesterase and inflammatory markers in the prognosis of stage ⅠA -ⅢA breast cancer[J]. Journal of International Oncology, 2024, 51(2): 73-82.
[9]	Jin Xudong, Chen Zhongjian, Mao Weimin.Research progress on the role of MTAP in malignant mesothelioma[J]. Journal of International Oncology, 2024, 51(2): 99-104.
[10]	Gu Huayan, Zhu Teng, Guo Guilong.Breast microbiota and breast cancer： present and future[J]. Journal of International Oncology, 2024, 51(1): 55-58.
[11]	Wang Jing, Xu Wenting.Value of NLR， CEA combined with coagulation indicators in the differential diagnosis of benign and malignant breast nodules with a diameter ≤ 1.0 cm[J]. Journal of International Oncology, 2023, 50(9): 520-526.
[12]	Feng Chengtian, Huang Furong, Cao Shiyu, Wang Jianyu, Nanding Abiyasi, Jiang Yongdong, Zhu Juanying.Relationships between HER2 protein expression and imaging features in HER2 positive breast cancer patients[J]. Journal of International Oncology, 2023, 50(9): 527-531.
[13]	Feng Dongxu, Wu Wei, Gao Pingfa, Wang Jun, Shi Lijuan, Chen Dawei, Li Wenbing, Zhang Meifeng.Effects of miR-451 on glycolysis and apoptosis of breast cancer cells by regulating Rho/ROCK1 pathway[J]. Journal of International Oncology, 2023, 50(8): 449-456.
[14]	Pan Shulan, Liu Chang, He Ping.Effect of fritinib on angiogenesis, tumor growth and IRE1-ASK1-JNK pathway in triple negative breast cancer[J]. Journal of International Oncology, 2023, 50(8): 457-462.
[15]	Zhang Lu, Jiang Hua, Lin Zhou, Ma Chenying, Xu Xiaoting, Wang Lili, Zhou Juying.Analysis of curative effect and prognosis of immune checkpoint inhibitor in the treatment of recurrent and metastatic cervical cancer[J]. Journal of International Oncology, 2023, 50(8): 475-483.