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

Abstract

Objective To 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. Methods A 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. Results The 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). Conclusion The 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