Capecitabine and Vinorelbine as an All-Oral Chemotherapy in HER2-Negative Locally Advanced and Metastatic Breast Cancer

Abstract

Background: The oral formulation of vinorelbine together with capecitabine allows for an all-oral combination chemotherapy which promises to raise quality of life of patients with advanced breast cancer. Patients and Methods: Patients with HER2-negative, locally advanced, inoperable or metastatic breast cancer were included in this prospective observational trial (treatment schedule: capecitabine 500 mg/m² twice daily, days 1–14; vinorelbine 60 mg/m², days 1+8; repeated in 3-week cycles). Results: All 32 patients (median age 50 years) were evaluable for toxicity, and 30 patients for response. Twentyfour patients received therapy as first-line treatment, and 8 patients as beyond first-line treatment. Median time to progression was 8 months, and median overall survival was 32 months. Complete response was observed in 1 patient (3%), partial response in 10 patients (33%), and disease stabilization for more than 6 months (SD > 6) in 10 patients (33%). This results in an overall response rate (ORR) of 37% and a clinical benefit rate (ORR + SD > 6) of 70%. The only grade 3/4 toxicities were neutropenia (19%) and hand-foot syndrome (9%). Conclusions: The all-oral combination of capecitabine/vinorelbine at this schedule appears to be an effective, well-tolerated regimen for treatment of advanced breast cancer, and offers a promising alternative to single-agent capecitabine and vinorelbine as well as intravenous polychemotherapy.

Safety and Therapeutic Effect of Metronomic Chemotherapy with Cyclophosphamide and Celecoxib in Advanced Breast Cancer Patients

“…Interestingly, we obtained similar results to those achieved with standard regimens administered to metastatic breast cancer patients but avoiding toxicity. Accordingly, the use of gemcitabine and carboplatin plus iniparib yielded a 56% OCB rate [25], while the administration of capecitabine and vinorelbine in HER2-negative patients reached a OCB rate of 70% [26] and the combination of paclitaxel with gemcitabine resulted in a 80% OCB rate [27].…”

Needs and Self-Care Efficacy for Cancer Patients Suffering from Side Effects of Chemotherapy

“…On the other hand, Kandasamy, Chaturvedi et al [ 31 ] suggested that spiritual well-being is an important component of health promotion and coping with the illness of cancer patients and is closely related to the physical and psychological symptoms of distress and they added that it should be addressed appropriately and adequately in a palliative setting.…”

“…Patient education and counseling can help reduce stress, improve coping skills, and can contribute to an improvement of the patients' health, which remains a high priority, especially in patients with metastatic disease. Inadequate health literacy, nonadherence, noncompliance, and other barriers present challenges to providing effective patient education [ 31 ].…”

A Phase I Study of UFT-Oral Vinorelbine in Metastatic Breast Cancer

“…The most common toxicities were hematological, including 12.9% of grade 3 neutropenia and 12.9% of grade 4 neutropenia; 9.7% of the patients had hand-foot syndrome. In May 2010, Gampenrieder et al [21 ]presented the results of a study associating capecitabine and oral vinorelbine (treatment schedule: capecitabine 500 mg/m 2 twice daily, days 1–14; vinorelbine 60 mg/m 2 , days 1 + 8; repeated in 3-week cycles). An overall clinical benefit rate of 70% was obtained.…”