Abstract
Capecitabine (X) and cyclophosphamide (C) can be administered orally and have synergistic effects with non-overlapping toxicities in patients with metastatic breast cancer (MBC). We administered XC therapy to heavily pretreated patients with MBC with excellent efficacy and minimal toxicity. A retrospective review was conducted of 67 patients with human epidermal growth factor receptor (HER) 2-negative MBC treated with XC therapy. The overall response rate was 41.8%. The median progression-free survival (PFS) was 9.2 months, and median overall survival (OS) was 31.5 months. The median PFS was 22.2 months in patients who suffered from hand-foot syndrome (HFS), but was 8.3 months in patients without HFS (p = 0.0003). HFS could be used as a prognostic factor. After disease progression (PD) was observed with administration of X (n = 7), additional administration of XC was effective (Response rate RR = 28.6%). After PD was observed with paclitaxel + bevacizumab (n = 12), XC was effective (RR = 33.3%). Grade 3 or 4 leukopenia was observed in 17.9%, and neutropenia was observed in 14.9% of patients. HFS was observed in 7.5% of patients, although no cases of grade 4 HFS occurred. Only two patients with grade 2 and 3 hemorrhagic cystitis interrupted therapy. XC therapy may be a promising oral chemotherapy that maintains good quality of life and is preferable for patients with MBC.
