Abstract
BackgroundCapecitabine has proven effective as a chemotherapy for metastatic breast cancer. Though several Phase II/III studies of capecitabine as neoadjuvant chemotherapy have been conducted, the results still remain inconsistent. Therefore, we performed a meta-analysis to obtain more precise understanding of the role of capecitabine in neoadjuvant chemotherapy for breast cancer patients.MethodsThe electronic database PubMed and online abstracts from ASCO and SABCS were searched to identify randomized clinical trials comparing neoadjuvant chemotherapy with or without capecitabine in early/operable breast cancer patients without distant metastasis. Risk ratios were used to estimate the association between capecitabine in neoadjuvant chemotherapy and various efficacy outcomes. Fixed- or random-effect models were adopted to pool data in RevMan 5.1.ResultsFive studies were included in the meta-analysis. Neoadjuvant use of capecitabine with anthracycline and/or taxane based therapy was not associated with significant improvement in clinical outcomes including: pathologic complete response in breast (pCR; RR = 1.10, 95% CI 0.87–1.40, p = 0.43), pCR in breast tumor and nodes (tnpCR RR = 0.99, 95% CI 0.83–1.18, p = 0.90), overall response rate (ORR; RR = 1.00, 95% CI 0.94–1.07, p = 0.93), or breast-conserving surgery (BCS; RR = 0.98, 95% CI 0.93–1.04, p = 0.49).ConclusionsNeoadjuvant treatment of breast cancer involving capecitabine did not significantly improve pCR, tnpCR, BCS or ORR. Thus adding capecitabine to neoadjuvant chemotherapy regimes is unlikely to improve outcomes in breast cancer patients without distant metastasis. Further research is required to establish the condition that capecitabine may be useful in breast cancer neoadjuvant chemotherapy.
Highlights
Neoadjuvant therapy, named preoperative therapy, was initially introduced to reduce the size or the extent of breast cancer in order to render the inoperable tumor operable, thereby permitting definitive surgery [1,2]
Inclusion Criteria To be considered eligible for inclusion in our meta-analysis, the study crieteria had to include:(a) a patient diagnosis of breast cancer without metastasis; (b) being a controlled trial; (c) using capecitabine in the neoadjuvant setting to treat breast cancer; (d) reporting relative risk (RR) with a 95% confidence interval (CI); if not, the reported data of outcomes pathologic complete response in breast (pCR), breast-conserving surgery (BCS) or overall response rate (ORR) were sufficient to calculate them; and (e) being written in the English language
Description of Eligible Studies A total of 5 trials [14,15,16,17,18] involving 3257 patients with early or operable breast cancer without distant metastasis were deemed to be eligible according to the inclusion criteria (Figure 1)
Summary
Neoadjuvant therapy, named preoperative therapy, was initially introduced to reduce the size or the extent of breast cancer in order to render the inoperable tumor operable, thereby permitting definitive surgery [1,2]. While polychemotherapy involving anthracycline or taxane remains the most widely used neoadjuvant regimen, an increasing number of new chemotherapeutics are being tested in clinical studies of breast cancer neoadjuvant therapy. Capecitabine is effective for salvage treatment of patients with metastatic breast cancer [5,6,7]. Capecitabine has proven effective as a chemotherapy for metastatic breast cancer. We performed a meta-analysis to obtain more precise understanding of the role of capecitabine in neoadjuvant chemotherapy for breast cancer patients
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
