Triple-negative breast cancer (TNBC) is difficult to treat due to the lack of targetable receptors, and patients often have poor outcomes due to the lack of effective treatment options. At the 2019 San Antonio Breast Cancer Symposium (SABCS), Marion van Mackelenbergh, MD (University of Kiel, Germany), presented results from a subgroup of patients with early-stage TNBC included in a meta-analysis of 12 clinical trials evaluating the impact of treatment with capecitabine in 15,457 patients with early-stage breast cancer (Abstract GS1-07). A total of 3,854 patients included in the analysis had TNBC.
Addition of capecitabine to standard chemotherapy resulted in significant improvements in both disease-free survival (DFS; HR 0.82, P = .004) and overall survival (OS; HR 0.78, P = .004) in patients with early-stage TNBC. Importantly, improvements in DFS and OS were only seen in studies where capecitabine was added to a standard chemotherapy regimen, and not in studies where capecitabine replaced another chemotherapy. Likewise, improvements in survival were only seen in patients with TNBC and not in the full analysis population, which included patients with HER2- and hormone receptor-positive breast cancer.
Dr van Mackelenbergh concluded that the addition of capecitabine to standard chemotherapy improves survival in patients with early-stage TNBC and represents a new and effective treatment approach in this hard-to-treat population. Priyanka Sharma, MD (University of Kansas, United States), the discussant of this study, agreed by saying that moving forward, adjuvant capecitabine should be considered as an add-on therapy for patients with early-stage TNBC, and particularly in patients with residual disease following neoadjuvant chemotherapy treatment.
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