Clinical Research Papers:
Efficacy and safety of capecitabine-based first-line chemotherapy in advanced or metastatic breast cancer: a meta-analysis of randomised controlled trials
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Weijiao Yin1,*, Guangsheng Pei2,*, Gang Liu1, Li Huang3, Shegan Gao1, Xiaoshan Feng1
1Department of Oncology, the First Affiliated Hospital of Henan University of Science and Technology, Luoyang, PR, China
2Department of Respiratory Medicine, the First Affiliated Hospital of Henan University of Science and Technology, Luoyang, PR, China
3Department of Gynecology, the First Affiliated Hospital of Henan University of Science and Technology, Luoyang, PR, China
*These authors have contributed equally to this work
Xiaoshan Feng, e-mail: email@example.com
Shegan Gao, e-mail: firstname.lastname@example.org
Keywords: capecitabine, breast cancer, first-line, meta-analysis
Received: July 09, 2015 Accepted: September 18, 2015 Published: September 30, 2015
We sought to evaluate the efficacy and safety of capecitabine-based therapy as first-line chemotherapy in advanced breast cancer. Randomised controlled trials of capecitabine monotherapy or combined treatment were included in the meta-analysis. PubMed, EMBASE, the Cochrane Library database and important meeting summaries were searched systematically. Outcomes were progression-free survival (PFS), overall survival (OS), overall response rate (ORR) and grades 3–4 drug-related adverse events.
Nine trials with 1798 patients were included. The results indicated a significant improvement with capecitabine-based chemotherapy compared with capecitabine-free chemotherapy in ORR (relative risk [RR] 1.14, 95% confidence interval [CI] 1.03 to 1.26, P = 0.013) and PFS (hazard ratio [HR] 0.77, 95% CI 0.69 to 0.87, P < 0.0001). Overall survival favoured capecitabine-based chemotherapy, but this was not significant. There were more incidences of neutropenia and neutropenic fever in the capecitabine-free chemotherapy group and more vomiting, diarrhoea and hand–foot syndrome in the capecitabine-based chemotherapy group. There were no significant differences in nausea, fatigue, cardiotoxicity or mucositis/stomatitis between the two treatment regimens.
Capecitabine-based chemotherapy significantly improves ORR and PFS in patients with advanced breast cancer, but has no demonstrable impact on OS. Capecitabine-based regimens are suitable as first-line treatment for patients with advanced breast cancer.
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