Additional Adjuvant Capecitabine in Early Breast Cancer Patients: A Meta-Analysis of Randomized Controlled Trials

Abstract

Aims: To assess the efficacy and safety of adjuvant capecitabine in early breast cancer patients. Methods: A literature search of databases was conducted to identify randomized controlled trials reporting the efficacy and toxicity of capecitabine as adjuvant therapy in early breast cancer patients. Results: Six studies were eligible and included a total of 6941 patients. Disease-free survival (hazard ratio = 0.79; 95% CI = 0.71–0.88; p < 0.0001) was significantly improved with additional capecitabine, whereas improvement in overall survival (OS) was not significant. The more pronounced benefits in both disease-free survival and OS were observed among triple-negative breast cancer patients. Conclusion: Additional capecitabine in the adjuvant setting conferred substantial disease-free survival benefit and a tendency toward improved OS. Triple-negative breast cancer patients can benefit from capecitabine irrespective of the administration sequence. Capecitabine may be considered a preferred additional treatment for early-stage triple-negative breast cancer patients, and sequential capecitabine can serve as an alternative choice for patients with poor tolerance.

A cost-effectiveness analysis of capecitabine maintenance therapy versus routine follow-up for early-stage triple-negative breast cancer patients after standard treatment from a perspective of Chinese society

“…Substantial survival benefits of adjuvant capecitabine therapy for early-stage TNBC have been demonstrated in previous literature [ 10 , 14 , 16 ]. The evidence of its cost-effectiveness is a pivotal consideration for treatment decision-making in developing countries, especially for those with limited health resources.…”

Capecitabine-based chemotherapy in early-stage triple-negative breast cancer: a meta-analysis

“…Focusing on the association of capecitabine and early TNBC, there were two meta-analyses recently (18,19). However, meta-analysis from Xun et al did not extract data from the TACT2 trial, which should be included as well (14,18).…”

“…In addition, the GAIN and GEICAM/2003-10 trials only consisted node-positive patients; in other words, they should be incorporated to the nodal status subgroup analysis as well (13, 15). Zhou et al included trials more rigorously, so subgroup analysis performed with less information (19).…”

“…There were also some conflicting survival data (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17). Recently, two meta-analyses were performed to explore the RCTs of capecitabine effect, but TNBCs were treated as a subgroup in these studies (18,19). To further determine the influence of adjuvant capecitabine on early-stage TNBC, we incorporated prospective randomized controlled trials (RCTs) in full text, performed a meta-analysis to get robust conclusions.…”