Abstract
Purpose
Triple-negative breast cancer (TNBC) pertains to a breast cancer subtype that has the highest metastatic and recurrence rates. The effectiveness of capecitabine as adjuvant chemotherapy for TNBC has remained unclear. This study conducted a meta-analysis of the efficacy of capecitabine as adjuvant chemotherapy for early-stage TNBC treated with taxane-/anthracycline-based chemotherapy.
Methods
We identified relevant research reports in online databases until May 2019. We finally included seven randomized clinical trials to perform this meta-analysis. Altogether, the seven trials enrolled 3151 early-stage TNBC patients, with 1552 receiving standard (neo)adjuvant chemotherapy regimens and 1599 receiving addition of capecitabine in the adjuvant settings besides standard regimens.
Results
A meta-analysis of the seven trials revealed a significant increase in disease-free survival (DFS) with the addition of capecitabine (Hazard ratio (HR) = 0.77, 95% CI 0.66–0.90). This improvement in DFS was significant both in trials conducted in America-Europe and in Asia. In trials involving six to eight cycles of capecitabine addition, we observed a significant improvement in DFS. Furthermore, in the meta-analysis of six trials, we detected a significant increase in overall survival (OS) favoring capecitabine (HR = 0.69, 95% CI 0.56–0.85).
Conclusions
Adjuvant addition of capecitabine to early-stage TNBC patients receiving standard chemotherapy showed significant DFS and OS improvement. Future studies involving the selection of patients that may have the highest survival benefit from adding capecitabine are warranted.
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Data availability
All data generated or analyzed during this study are included in this article.
Abbreviations
- TNBC:
-
Triple-negative breast cancer
- ER:
-
Estrogen receptor
- PR:
-
Progesterone receptor
- HER2:
-
Human epidermal growth factor receptor 2
- OS:
-
Overall survival
- DFS:
-
Disease-free survival
- RCT:
-
Randomized clinical trial
- HR:
-
Hazard ratio
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Acknowledgements
We thank Gillian Li and Gilbert Li for their enlightening advice.
Funding
This work was supported by the Fundamental Research Funds for the Central Universities (3332019023).
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Conception and design: Y Li, Y Zhou, F Mao, Q Sun; Administrative support: Y Li, Q Sun; Data analysis and interpretation: Y Li, Y Zhou, F Mao, Y Lin, X Zhang, S Shen; Manuscript writing: all of the authors; Final approval of manuscript: all of the authors.
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Li, Y., Zhou, Y., Mao, F. et al. Adjuvant addition of capecitabine to early-stage triple-negative breast cancer patients receiving standard chemotherapy: a meta-analysis. Breast Cancer Res Treat 179, 533–542 (2020). https://doi.org/10.1007/s10549-019-05513-4
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DOI: https://doi.org/10.1007/s10549-019-05513-4