Adjuvant capecitabine in combination with docetaxel and cyclophosphamide plus epirubicin for breast cancer: an open-label, randomised controlled trial

Joensuu, Heikki; Kellokumpu‐Lehtinen, Pirkko‐Liisa; Huovinen, Riikka; Jukkola-Vuorinen, Arja; Tanner, Minna; Asola, R.; Kokko, R.; Ahlgren, Johan; Auvinen, Päivi; Hemminki, Akseli; Paija, Outi; Helle, Leena; Nuortio, Lauri; Villman, Kenneth; Nilsson, Greger; Lahtela, Sirpa-Liisa; Lehtiö, Kaisa; Pajunen, Marjo; Poikonen, Paula; Nyandoto, Paul; Kataja, Vesa; Bono, Petri; Leinonen, Mika; Lindman, Henrik

doi:10.1016/s1470-2045(09)70307-9

Cited by 62 publications

(60 citation statements)

References 23 publications

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“…A preplanned subgroup analysis of triple-negative tumours showed a very high pCR rate of 48% in the capecitabine arm as compared to only 13% in non-triple-negative tumours [27]. This is in good accordance with results of the Finnish adjuvant FinXX trial [28] in patients with moderate-to-high-risk early breast cancer where recurrence-free survival at 3 years followup was significantly better with the capecitabine regimen than in the standard control arm (93 vs. 89%; hazard ratio (HR) 0.66; 95% CI 0.47-0.94; p = 0.020). In an explorative analysis of this study, the triple-negative subgroup especially profited from capecitabine in terms of recurrence-free survival with a HR of 0.43 (p = 0.024) [29].…”

Section: Capecitabinesupporting

confidence: 68%

Trends and Novel Approaches in Neoadjuvant Treatment of Breast Cancer

Steger¹,

Bartsch²

2011

Breast Care

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Breast cancer is the most prevalent malignant disease in women worldwide. Traditionally, surgical tumour resection was the primary step within the treatment algorithm of early stage disease; systemic therapy in order to reduce the rate of systemic recurrences followed. National Surgical Adjuvant Breast and Bowel Project (NSABP) trial B-18 found that pre- and postoperative administration of chemotherapy was equally effective. This study therefore established neoadjuvant chemotherapy as a valid treatment option, as the breast conservation rate is increased. Modern neoadjuvant regimens encompassing anthracyclines and taxanes yield pathological complete response (pCR) rates of around 20%, with higher efficacy observed in triple-negative tumours. The antibody trastuzumab is the first targeted agent established in neoadjuvant regimens for the treatment of Her2-positive breast cancer, as it raised pCR rates up to 50%. Novel approaches are aiming to increase the efficacy of neoadjuvant therapy. Inclusion of capecitabine might further increase pCR rates in selected patients, although data are not unanimous throughout the respective clinical trials. In patients harbouring BRCA-1 germline mutations, platinum derivatives are apparently promising. Novel Her2-targeted agents such as lapatinib and pertuzumab are currently under investigation in several clinical trials, while the role of bevacizumab, a monoclonal antibody inhibiting angiogenesis, awaits future clarification.

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Section: Capecitabinesupporting

confidence: 68%

Trends and Novel Approaches in Neoadjuvant Treatment of Breast Cancer

Steger¹,

Bartsch²

2011

Breast Care

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“…Other trials, which were not confounded by a lower taxane dose, showed a benefit for the addition of capecitabine [23,24]. The simultaneous use of trastuzumab during neoadjuvant chemotherapy has consistently shown higher pCR rates in HER2-positive breast cancer [25,26].…”

Section: Discussionmentioning

confidence: 99%

Impact of treatment characteristics on response of different breast cancer phenotypes: pooled analysis of the German neo-adjuvant chemotherapy trials

Minckwitz

Untch

Nüesch

et al. 2010

Breast Cancer Res Treat

239

129

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2 Abstract PurposePathological complete response (pCR) to neoadjuvant treatment correlates with outcome in breast cancer. We determined whether characteristics of neoadjuvant therapy are associated with pCR. MethodsWe used multi-level models, which accounted for heterogeneity in pCR across trials and trial arms, to analyze individual patient data from 3332 women included in 7 German neoadjuvant trials with uniform protocols.

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“…2 However, this is not the first time the Finland Capecitabine Trial, also known as FinXX, has been presented. It was reported in full in Lancet Oncology in 2009, 3 and at that point, capecitabine showed a benefit for the whole population. How can the result of a trial change?…”

mentioning

confidence: 84%

“…1 This seems a prudent recommendation and is in keeping with earlier observations. [3][4][5] By extension, one cannot recommend MRI surveillance with the hope that chemotherapy can be avoided if the cancer is caught early enough.…”

Section: Author's Disclosures Of Potential Conflicts Of Interestmentioning

confidence: 99%