249P A retrospective analysis on capecitabine and vinorelbine combination in metastatic breast cancer: The MARCELLINO study

Abstract

Capecitabine (cape) and vinorelbine (vino) are known effective drugs for metastatic breast cancer (mBC) and have been successfully used in combination in the past, especially in the pre-CDK4/6i era. No literature data are available comparing the combined regimen (concCV) with a sequential regimen (seqCV). We retrospectively analysed a cohort of 188 consecutive mBC patients (pts) treated with concCV or seqCV between January 2010 and December 2016 at IRCCS CRO of Aviano and ASUFC Academic Hospital of Udine. Only pts receiving the two drugs in direct sequence were considered for seqCV. For concCV, data on eventual maintenance therapy (MT) with either endocrine therapy (ET) or single-agent chemotherapy (CT) were collected. CV reintroduction at disease progression (PD) was considered only if immediately after MT. The association of CV regimen with survival outcomes was explored by the Kaplan-Meier method. PFS for concCV was compared to the sum of PFS for single drugs of seqCV. Median age at diagnosis was 51 years (yrs) [44;60], median age at metastatic disease was 57 yrs [49;66]. 20% of pts were classified as de novo metastatic. At diagnosis, 90% of pts were luminal-like, while 10% had a triple negative BC. Disease re-biopsy on a metastatic lesion was performed in 51% of pts (with a phenotype change in 18% of cases). Median number of treatment lines in the advanced setting was 5 [4;7], median line for CV regimen was 2 [2;3]. In total 138 pts (73%) received concCV, while 50 pts (27%) received seqCV (82% with cape as first drug). MT was offered in 67 pts (36%), with a median duration of 8 months (m) [6;14]. ET (mainly aromatase inhibitors, in 49% of cases) or cape/vino (in 12% and 10%, respectively) were used as MT. CV was reintroduced after MT at PD in 18 pts (27%). Overall, mPFS was 11 m [6;22] and mOS was 24.5 m [13.5;45.3] from CV start. In concCV pts, mPFS was 10 m [5;19] (mPFS2 was 18 m [9;31] with CV reintroduction) and mOS was 27.3 m [13.7;52.6]. In seqCV pts, total mPFS was 11 m [7;20] and mOS was 19.3 m [13.3;37.4]. According to our retrospective data, concCV and seqCV seem to be comparable in terms of survival outcomes, with the limits of a reduced sample size and unbalanced treatment arms.