Oral Capecitabine-Vinorelbine Is Associated with Longer Overall Survival When Compared to Single-Agent Capecitabine in Patients with Hormone Receptor-Positive Advanced Breast Cancer

Abstract

Background: Single-agent capecitabine (C) is a moderately effective chemotherapeutic compound in the treatment of patients with HER2-negative metastatic breast cancer (mBC). The capecitabine-vinorelbine (CV) combination is also used due to a good tolerability profile, but no studies have demonstrated its superiority over single-agent C. Methods: We conducted a retrospective analysis to compare overall response rate (ORR), progression-free survival (PFS), overall survival (OS) and incidence of adverse events (AEs) in patients with HER2-negative mBC treated with CV vs. single-agent C. Results: Out of 290 patients included in this study, 127 (43.8%) received single-agent C, while 163 (56.2%) patients were treated with CV. Median PFS was similar in patients treated with single-agent C or CV, while CV was associated with significantly longer OS in patients with hormone receptor-positive (HR+) BC. This OS advantage was confirmed at multivariable analysis also after propensity score-based matching of patients according to relevant clinical or tumor characteristics. When compared with single-agent C, CV was associated with higher incidence of G3/G4 and any-grade nausea/vomiting, diarrhea and increased transaminases. Conclusions: While prospective studies are Cancers 2020, 12, 617 2 of 15 needed to confirm our findings, the potential OS advantage of CV over single-agent C in HR+ mBC patients must be weighed against a significantly higher incidence of AEs.

Metronomic vinorelbine is an excellent and safe treatment for advanced breast cancer: a retrospective, observational study

“…There were no significant differences of median TTF within subtypes, except for TNBC patients. This subtype was the most important risk factor for worse PFS and OS, especially for single agent MCT 19 .…”

A Complete Response of Orbital Metastases in Breast Cancer Patient Treated with Oral Chemotherapy: Case Report and Literature Review

“…Oral capecitabine/vinorelbine have been considered the agents of choice in relapsed BC after both previous anthracyclines and taxanes [ 34 ]. This combination is effective and well tolerated [ 35 ] with an improvement in the overall survival [ 36 ]. ER-positive BCs carry substantial risk of late recurrence [ 37 ] and adjuvant therapy with aromatase inhibitors such as letrozole has led to a reduction in new or recurrent BCs and improved rates of disease-free survival [ 38 ].…”

Final Results of RIGHT Choice: Ribociclib Plus Endocrine Therapy Versus Combination Chemotherapy in Premenopausal Women With Clinically Aggressive Hormone Receptor–Positive/Human Epidermal Growth Factor Receptor 2–Negative Advanced Breast Cancer

“…5,6 Several regimens (eg, docetaxel plus capecitabine, paclitaxel plus gemcitabine, or capecitabine plus vinorelbine) have demonstrated superior efficacy to that of single-agent CT but are associated with higher incidences of adverse events (AEs). [7][8][9][10][11][12][13] Combination CT continues to be preferred in patients with critical disease features because of the need for a more rapid response and higher response rate in these patients. [7][8][9][10][11][12][13] However, unlike the clear preference for CT for HR-ABC treatment, CT is generally less effective in HR1 ABC.…”

“…[7][8][9][10][11][12][13] Combination CT continues to be preferred in patients with critical disease features because of the need for a more rapid response and higher response rate in these patients. [7][8][9][10][11][12][13] However, unlike the clear preference for CT for HR-ABC treatment, CT is generally less effective in HR1 ABC. 14 Thus, an unmet medical need exists in the HR1/HER2-ABC patient population for therapy options that provide a rapid response and durable efficacy while sparing patients the toxicities associated with combination CT.…”