Capecitabine monotherapy for patients with brain metastases from advanced breast cancer

Abstract

1102 Background: To assess the efficacy of capecitabine monotherapy for patients with chemotherapy-pretreated advanced breast cancer with brain metastases. Methods: Patients with brain metastases from breast cancer whose disease had progressed on prior chemotherapy for advanced disease received oral capecitabine 1,000 mg/m2 bid on days 1–14 every 3 weeks until disease progression. Results: Between July 2007 and August 2008, 10 women were treated. Median age was 50 years (range 36–66 years). ECOG performance status was 1 in 7 patients and 2 in 3 patients. All had received prior chemotherapy: one line in five patients; two lines in four patients; three lines in one patient. Six patients had received prior endocrine therapy and three had received prior salvage radiotherapy to the brain. Two patients had metastases limited to the brain and the remaining eight also had extracranial metastases. All patients were assessable for response. Six achieved a partial response in the brain (CT/enhanced-contrast MRI), three showed disease stabilization, and one had disease progression as best response. Median duration of response was 4 months and median time to progression was 6 months. Seven patients are still alive and therefore median overall survival has not been reached. A total of 58 cycles of capecitabine were delivered. The most common toxicities (% of cycles) were neutropenia (G1/2 43.1%, G3/G4 8.6%), hand-foot syndrome (G1/2 25.9%, G3 8.6%), anemia (G1/2 29.3%, G3 1.7%), diarrhea (G1/2 20.6%, G3 5.2%), nausea/vomiting (G1/2 24.1%), stomatitis (G1/2 12%), thrombocytopenia (G1 8.6%), and fatigue (G1/2 6.9%). Conclusions: Our small study suggests that capecitabine has pronounced anticancer activity in patients with brain metastases from breast cancer with reasonable tolerability and easy administration as outpatient treatment. Further investigation is warranted. No significant financial relationships to disclose.