Documentation of capecitabine usage as a third-line chemotherapy option for metastatic breast cancer patients

Abstract

Objective. To document options metastatic breast cancer (MBC) patients chose for third-line chemo-therapy within the Alberta Cancer Board (ACB) between December 1995 to April 2000. To record the early market experience with capecitabine use in MBC. Methods. Treatment of MBC with a marketed taxane between December 1995 and April 2000 was reviewed. Patients were included if they were within treatment guidelines of the Alberta Cancer Board Outpatient Cancer Drug Benefit Program, and excluded if they were currently on a taxane, treated outside guidelines, or died before receiving a third-line agent. Pre- and postcapecitabine availability cohorts were used to compare prescribing patterns. Results. Before the availability of capecitabine, vinorelbine was the most prescribed third-line chemotherapy (18.8%). After its availability, cape-citabine was the most prescribed third-line chemo-therapy (44.9%). Patients experienced, in order of decreasing frequency, hand-foot syndrome, diarrhea, and nausea as side effects of capecitabine. The majority of dose changes to capecitabine were side effect-related. The first dose was decreased on average by 24.2%, and the sum of the first and second dose adjustments averaged 44.2%. For patients who have discontinued capecitabine, 66.7% were due to disease-related reasons. Conclusion. At the ACB, capecitabine is the current primary choice of third-line chemotherapy. During early experience with its usage, capecitabine was well tolerated and toxicity was adequately managed by dose adjustments. J Oncol Pharm Practice (2001) 6, 138-145.