Hafeez M, Shaharyar, Kafait Ahmad, Manzer Zikrya, Ahmed Usman.
Single agent low dose Capecitabine subsequent to Docetaxel chemotherapy in HER-2 negative metastatic breast cancer.
Biomedica Jan ;25(2):150-3.

The objective of this study was to evaluate the efficacy and toxicity of low dose capecitabine chemotherapy in patients with metastatic breast cancer (MBC) who have previously received first line docetaxel chemotherapy. Metastatic breast cancer patients who responded or achieved a stable disease with first line docetaxel were enrolled. Female patients with visceral or visceral and bone metastases and a KPS > 70 were eligible. Adequate marrow, renal and hepatic function was required. Metastatic brain disease and bone as the only site of disease were excluded. Informed consent was obtained from all patients. Capecitabine 1,000 mg/m2 B.I.D 14 days for four cycles were given. Cycles were repeated every 3 weeks. Response Evaluation Criteria in Solid Tumors (RECIST) was used for evaluation of response and common Toxicity Criteria (CTC) Version 3.0 for evaluation of toxicity. From September 2006 to December 2007, 38 patients were enrolled. Median age was 49 years (Range 32-70). Thirty six patients had received docetaxel at a dose of 75 mg/m2 for four cycles. Six patients had already achieved a complete response, 20 partial response and ten had achieved stable disease. Capecitabine added one CR (3.33%) and six partial responses (20 %). Median time to progression after capecitabine was 6.9 months (range, 3-22 months) and at a median follow up time of 24 months (range, 16 -34 months) 13 patients have died with an overall survival probability of docetaxel – capecitabine sequential therapy of 0.68. Significant grade 3 toxicities included hand-foot syndrome in three patients (8.33%), diarrhea in 2 (5.56%), stomatitis, dermatitis, fatigue and decrease in appetite in one patient (2.78 %) each. Grade 2 toxicity included hand-foot syndrome in 12 (33.33%) patients, diarrhea and stomatitis in 8 patients (22.22%) each. Most common hematological toxicity included lymphopenia and anemia seen in 16 (44.44%) and 14 (38.89%) respectively. This treatment schedule of low dose capecitabine after docetaxel treatment is an effective treatment of MBC and has a manageable toxicity profile.

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