Capecitabine In Breast Cancer Research Articles

Radiation recall dermatitis following adjuvant capecitabine in breast cancer: A case report

Radiation recall dermatitis (RRD) is an acute inflammation of the skin, i.e., produced by drugs, most commonly chemotherapeutic treatments, in an area of the body that has been treated with radiation in the past. This case report describes the clinical experience of a triple-negative breast cancer patient who developed RRD after postoperative radiotherapy following adjuvant capecitabine treatment. The timing of chemotherapy after radiation therapy and the improvement in radiation dermatitis following capecitabine avoidance suggest that the reaction was a true radiation recall phenomenon.

Stroke-like presentation of acute toxic leukoencephalopathy due to capecitabine treatment with extensive intramyelinic edema.

Stroke-like presentation of acute toxic leukoencephalopathy due to capecitabine treatment with extensive intramyelinic edema.

Effect of a Novel Soaking Solution Used in Patients With Hand-Foot Syndrome as a Result of Capecitabine Treatment: A Randomized and Self-Controlled Trial

BackgroundHand-foot syndrome (HFS) is a common adverse event in patients receiving capecitabine therapy for breast cancer, and the symptoms of HFS significantly impair patient quality of life. However, currently there are no effective drugs or measures to prevent and alleviate the occurrence of HFS. AimTo assess the effectiveness of a novel soaking solution, a mixture solution of dexamethasone, gentamicin and vitamin B12, in patients with grade 2-3 HFS after capecitabine treatment for breast cancer. Materials and MethodsPatients with grade 2-3 HFS according to the National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE) were enrolled in this randomized, single-center, self-controlled trial. Each patient's right and left hands or feet were individually randomized to soak in either a novel soaking solution (treated hands or feet) or a placebo liquid (control hands or feet) for three times a day, each time for 15 minutes and for four weeks. Effectiveness was evaluated according to CTCAE grades, defined as a reduction of 1 or more CTCAE grades. ResultsA total of 60 patients were enrolled. The HFS CTCAE grade of the treated hands and feet at 4 weeks of HFS treatment was significantly decreased compared to that of the control hands and feet (P = .005). Significant differences were also observed between the treatment conditions in terms of the HFS effectiveness rate: treated group 80% and placebo group 51.7% (P = .001). No adverse or unexpected events were observed during the whole trial. ConclusionSoaking affected hands or feet in a novel soaking solution safely and effectively reduced the severity of HFS following treatment with capecitabine for breast cancer.

HER2 targeted biological macromolecule modified liposomes for improved efficacy of capecitabine in breast cancer

The present research reports the beneficial effects of surface modified chitosan and tumor-homing peptide conjugated liposomes of capecitabine (CAP) for treating breast cancer. Liposomal formulation of CAP was prepared by film hydration method using cholesterol-THP conjugate (CTHP-CAP-LPs) to achieve active targeting through HER2 receptors. CTHP-CAP-LPs significantly improved the specificity and efficacy of CAP by improving cell uptake, cytotoxicity and tumor regression in tumor bearing mice. CTHP-CAP-LPs, therefore, is a promising approach to improve the anticancer effects of CAP.

Abstract OT1-05-04: Phase 3 trial of carboplatin in triple negative breast cancer (TNBC) patients with residual invasive carcinoma after neoadjuvant chemotherapy (JONIE4:J-CAT trial)

Abstract Background: It is well known that the prognosis of non pCR TNBC patients was poor after anthracycline and taxan treatment. For such patients, capecitabine seems to be effective to reduce recurrence based on the HR 0.58 of the CREATE X trial (Masuda, N. et al. Adjuvant Capecitabine for Breast Cancer after Preoperative Chemotherapy. N Engl J Med. 376, 2147. 2017) . However, the target of capecitabine is still unclear for TNBC. We classified non pCR tumors as BRCAness and Sporadic using BRCAness test(MRC-Holland, Amsterdam, the Netherlands). The recurrence rate of the BRCAness group was about 70%. Carboplatine is expected to be effective against BRCAness tumors, as it is a DNA damaging agent. In this study BRCAness can be checked just before carboplatin treatment using surgical specimens. Then the efficacy of carboplatin will be directly known to make comparison between DFS in the carboplatin group and that of the observation group. Trial design: This is anopen label, randomized phase III study that will enroll TNBC with residual invasive cancer after surgery with preoperative chemotherapy including both anthracycrine and taxan. Patients are randomly assigned to either the carboplatin group or observation group. The patients in the carboplatin group are treated with carboplatin at AUC 6 and those in the observation group are observed at only 3 years. Eligibility criteria: 1) ER and PgR<1%, HER2 0, 1+ or 2+ with FISH negative on core needle biopsy before the chemotherapy and surgical specimens. 2) Preoperative chemotherapy including both anthracycrine and taxan. 3) Residual invasive cancer on breast tumors or lymph node metastasis in surgical specimens. 4) 20-79 year old women. 5) No chemotherapy within 5 years. 6) Not bilateral breast cancer, without metastasis, no prior breast cancer. 7) No severe bone marrow suppression. Specific aims:Primary objective is DFS (Disease Free Survival). Secondary objectives are overall survival and safety. STATISTICAL METHODS: The 3 years recurrence rate of the observation group was estimated as 40% and hazard ratio at 0.58 based on the CREATE X trial. For both groups, 135 patients are necessary. This study is powered to approximately 80% to test the superiority of carboplatin group at a 2-sided α=0.05 using a stratified log-rank test. Activation Date:22ndMarch 2018. No patients had been enrolled till 3rd July. Citation Format: Tanino H, Suzuki M, Kaise H, Miyashita M, Chishima T, Hayashi M, Miyoshi Y, Futamura M, Ohtani S, Nagahashi M, Ohta T, Kosaka Y, Ishikawa T, Hasegawa Y, Kubota T, Sangai T, Iwatani T, Yamada A, Akazawa K, Kohno N. Phase 3 trial of carboplatin in triple negative breast cancer (TNBC) patients with residual invasive carcinoma after neoadjuvant chemotherapy (JONIE4:J-CAT trial) [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr OT1-05-04.

Evaluation of the clinical benefits of adjuvant capecitabine monotherapy in elderly women with breast cancer: A retrospective study.

Capecitabine is orally administered and may be safely and conveniently used in patients with cancer. The antitumor activity of capecitabine in breast cancer was mostly demonstrated in the salvage therapy setting, whereas the effect of adjuvant capecitabine monotherapy in breast cancer remains unclear. The aim of the present study was to evaluate adjuvant capecitabine monotherapy in elderly women with breast cancer. A total of 251 patients were enrolled and survival was compared between elderly breast cancer patients who received adjuvant capecitabine monotherapy and those who received no chemotherapy. Cancer-specific and disease-free survival curves were compared using log-rank tests and survival curves were calculated using the Kaplan-Meier method. Multivariate analyses were conducted using Cox's proportional hazard regression model. There was no significant difference between the clinicopathological characteristics, including age, tumor size, lymph node status, histological grade and hormone status, between patients in the two groups. The breast cancer-specific survival rate was 89.3% in the capecitabine monotherapy group vs. 81.3% in the no chemotherapy group; the difference was not statistically significant (P=0.128). The disease-free survival rate was 81.7% in the capecitabine monotherapy group vs. 65.3% in the no chemotherapy group. Kaplan-Meier analysis indicated a longer disease-free survival in the capecitabine monotherapy group (P=0.015). On Cox regression analysis, capecitabine monotherapy was found to be associated with the disease-free survival rate (P=0.014, hazard ratio=0.500) but not with the cancer-specific survival rate (P=0.181). The adverse events of capecitabine monotherapy were recorded and there was no chemotherapy interruption due to severe adverse reactions. Therefore, adjuvant capecitabine monotherapy in elderly women with breast cancer is a safe and effective option, as well as a viable alternative for elderly breast cancer patients who refuse standard adjuvant therapy.

A comparison of toxicity profiles between the lower and standard dose capecitabine in breast cancer: a systematic review and meta-analysis

A comparison of toxicity profiles between the lower and standard dose capecitabine in breast cancer: a systematic review and meta-analysis

Synergistic antitumor interaction between valproic acid and capecitabine in breast cancer

Meeting abstracts Capecitabine, commonly used in different settings for metastatic breast cancer, is an inactive prodrug that take advantage of the tumor elevated levels of thymidine phosphorylase (TP), a key enzyme for its conversion to 5-florouracil. Potentiation of anticancer activity of

Capecitabine in Breast Cancer: The Issue of Cardiotoxicity During Fluoropyrimidine Treatment

Capecitabine is an orally available fluoropyrimidine carbamate that selectively delivers fluorouracil (5-FU) to tissues expressing high levels of thymidine phosphorylase (TP) such as tumors. The drug has demonstrated efficacy in metastatic breast cancer, colorectal, and pancreatic cancer. Although these are considered safe drugs, a growing body of literature reports adverse cardiac effects. Clinical trials indicate that capecitabine has a cardiac toxicity similar to that of infused fluoropyrimidines such as 5-FU. Here, we review cardiotoxicity in the use of fluoropyrimidines, with particular attention toward capecitabine. We also describe a severe, reversible cardiac event that occurred in a 39-year-old woman, with no cardiac risk factors, treated with capecitabine for advanced breast cancer. This review and our experience confirm that fluoropyrimidine cardiotoxicity is an infrequent but documented side effect. Oncology patients under treatment should be closely observed and monitored for cardiac symptoms with particular attention in case of signs or symptoms of cardiovascular complications. The implementation of cardio-oncology interdisciplinary teams should, in the future, reduce the impact of cancer treatment-associated cardiotoxicity syndromes.

Gene expression pathway analysis to predict response to neoadjuvant docetaxel and capecitabine for breast cancer

Neoadjuvant chemotherapy has been shown to be equivalent to post-operative treatment for breast cancer, and allows for assessment of chemotherapy response. In a pilot trial of docetaxel (T) and capecitabine (X) neoadjuvant chemotherapy for Stage II/III BC, we assessed correlation between baseline gene expression and tumor response to treatment, and examined changes in gene expression associated with treatment. Patients received four cycles of TX. Tumor tissue obtained from Mammotome core biopsies pretreatment (BL) and post-cycle 1 (C1) of TX was FLash frozen and stored at -70 degrees C until processing. Gene expression analysis utilized Affymetrix HG-U133 Plus 2.0 GeneChip arrays. Statistical analysis was performed using BRB Array Tools after RMA normalization. Gene ontology (GO) pathway analysis used random variance t tests with a significance level of P\0.005. For gene categories identified byGO pathway analysis as significant, expression levels of individual genes within those pathways were compared between classes using univariate t tests; those genes with significance level of P\0.05 were reported. PAM50 analyses were performed on tumor samples to investigate biologic subtype and risk of relapse (ROR). Using GO pathway analysis, 39 gene categories discriminated between responders and non-responders,most notably genes involved in microtubule assembly and regulation. When comparing pre- and post-chemotherapy specimens, we identified 71 differentially expressed gene categories, including DNA repair and cell proliferation regulation. There were 45 GO pathways in which the change in expression after one cycle of chemotherapy was significantly different among responders and nonresponders. The majority of tumor samples fell into the basal like and luminal B categories. ROR scores decreased in response to chemotherapy; this change was more evident in samples from patients classified as responders by clinical criteria. GO pathway analysis identified a number of gene categories pertinent to therapeutic response, and may be an informative method for identifying genes important in response to chemotherapy. Larger studies using the methods described here are necessary to fully evaluate gene expression changes in response to chemotherapy.

A retrospective review of breast cancer patients with central nervous nystem metastasis treated with capecitabine

1098 Background: In all of the major studies on the effects of capecitabine in metastatic breast cancer (MBC) patients with central nervous system (CNS) metastasis were categorically excluded, understandably due to the poor outcome associated with such advanced disease, and as a consequence, the data are limited on such cases. The aim of this study was to evaluate the effectiveness and toxicity of capecitabine in breast cancer patients with CNS metastasis. Methods: The records of all patients with MBC presenting to the Department of Medical Oncology at Hacettepe University Hospital, Ankara, Turkey, for treatment between December 2001 and December 2005 were evaluated. Patients who recieved capecitabine as a sole agent for MBC with CNS metastasis were included in the study. All patients recieved capecitabine at a dose of 2,500mg/m2/day for 14 days at 3 weeks intervals. Results: Twenty patients were included in this retrospective analysis. All were female with a median age of 38 years (range, 20–58) at the diagnosis and the median time to brain metastasis was 3.9 years (range, 0.5–19.6). Three patients had undergone surgery for CNS metastasis, and all patients had recieved whole brain radiotherapy before the capecitabine treatment. A total of 159 cycles of chemotherapy were introduced and for each patient median number of chemotherapy cycles were 6.5 (range 1–28 cycles). Nine of them were given capecitabine as first-line chemotherapy after brain metastasis. There were 2 (10%) complete (one patient had metastasectomy for brain metastasis), and 7 (35%) partial responses with 6 (30%) patients having stable disease. Progressive disease was observed in 5 (25%) patients. Overall response rate was 45%. Median progression free survival time was 7.3 months (range 1.8–26.7). Adverse effects were seen in 13 patients, with grade 3 hand food syndrome occuring in 5 patients resulting in dose reduction. Grade II neutropenia was observed in 1 patient. Conclusions: Capecitabine is effective and well tolerated in the treatment of breast cancer patients with CNS metastases. No significant financial relationships to disclose.

Improved QOL with capecitabine in breast cancer

Improved QOL with capecitabine in breast cancer

Improved QOL with capecitabine in breast cancer

Improved QOL with capecitabine in breast cancer

Clinical evaluation on preoperative chemotherapy of capecitabine in breast cancer of III clinical stage

目的 探讨临床Ⅲ期乳腺癌术前应用卡培他滨化疗的意义.方法将2000年1月2004年1月诊断的64例Ⅲ期乳腺癌随机分为两组:卡培他滨组和CAF组(环磷酰胺+阿霉素+5-氟尿嘧啶),每组各32例.分别应用卡培他滨和CAF术前化疗3个周期.结果卡培他滨组临床有效率为81.3%,CAF组临床有效率为49.3%,两组有效率比较差异有显著意义(P<0.05),且卡培他滨组临床毒副作用少.结论卡培他滨应用Ⅲ期乳腺癌术前化疗能提高临床有效率,减少毒副作用。

The Evolving Role of Capecitabine in Breast Cancer

Breast cancer is the most common cancer and the second greatest cause of cancer-related death among women in the United States. Capecitabine is a selectively tumor-activated fluoropyrimidine carbamate that is converted to 5-fluorouracil by the sequential activity of these enzymes, the final of which is thymidine phosphorylase, which is overexpressed in many human cancers. Capecitabine as a single agent and in combination with other drugs is efficacious in previously treated and untreated metastatic breast cancer (MBC). The integration of capecitabine, either as a single agent or in combination with docetaxel, into adjuvant breast cancer therapy is justified due to its high antitumor activity in previously treated and untreated MBC, its tolerability, lack of cross-resistance with the anthracyclines and taxanes, and because combined docetaxel/ capecitabine improves the overall survival of patients with MBC. Capecitabine is being evaluated as preoperative therapy in patients with operable breast cancer, as adjuvant therapy in patients with high-risk node-negative or node-positive disease, and as oral single-agent therapy in women ≥ 65 years of age. This article is an overview of published studies of capecitabine in MBC and the studies that are planned or have been proposed to evaluate capecitabine as adjuvant therapy for breast cancer.

Commentary on “Capecitabine in Breast Cancer: Current Status”

Commentary on “Capecitabine in Breast Cancer: Current Status”