title: Survival differences observed in metastatic breast cancer patients treated with capecitabine when compared with vinorelbine after pretreatment with anthracycline and taxane.
abstract: OBJECTIVE
  The optimal treatment of metastatic breast cancer patients previously treated with anthracycline and taxane is unknown. Common therapeutic alternatives include capecitabine and vinorelbine. This retrospective chart review compares overall survival following treatment with capecitabine, vinorelbine, or both agents sequentially in this group of women.
  
  
  METHODS
  Electronic patient records and charts of patients who received anthracycline and taxane-based chemotherapy and subsequently received capecitabine and/or vinorelbine at 3 Canadian cancer centers, between November 1994 and June 2003, were retrospectively reviewed.
  
  
  RESULTS
  A total of 140 patients met the study eligibility criteria: 45 patients received vinorelbine as a single agent and 68 received capecitabine as a single agent. The median duration of therapy was 64 days with vinorelbine and 129 days with capecitabine (P = 0.0012). Median overall survival was 102 days for the vinorelbine group and 188 days for the capecitabine group (P < 0.0001). Survival at 1 year was 15.6% for the vinorelbine group and 28.4% for the capecitabine group (P = 0.017). Twenty-seven patients received both agents sequentially; and in this group, the median duration of therapy was 110 days (87 days with vinorelbine and 138 days with capecitabine), and the median overall survival was 390 days.
  
  
  CONCLUSIONS
  This exploratory analysis suggests that patients with tumors previously treated with both anthracycline and taxane can still obtain significant survival benefit from further chemotherapy. The results indicate that capecitabine may be superior to vinorelbine in this setting.
authors.affiliation: Sunnybrook and Women's College Health Sciences Centre, Toronto, Ontario, Canada. sunil.verma@sunnybrook.ca
authors.forename: Sunil
authors.initials: S
authors.lastname: Verma
authors.forename: Nan Soon
authors.initials: NS
authors.lastname: Wong
authors.forename: Maureen
authors.initials: M
authors.lastname: Trudeau
authors.forename: Anil
authors.initials: A
authors.lastname: Joy
authors.forename: John
authors.initials: J
authors.lastname: Mackey
authors.forename: George
authors.initials: G
authors.lastname: Dranitsaris
authors.forename: Mark
authors.initials: M
authors.lastname: Clemons
mesh_terms: D000328:Adult; D000368:Aged; D018943:Anthracyclines / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000401:mortality*; D001952:Bridged-Ring Compounds / Q000008:administration & dosage; D000069287:Capecitabine; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000031:analogs & derivatives; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies; D016019:Survival Analysis; D043823:Taxoids / Q000008:administration & dosage; D014747:Vinblastine / Q000008:administration & dosage / Q000031:analogs & derivatives; D000077235:Vinorelbine
chemical_list: D018943:Anthracyclines; D001952:Bridged-Ring Compounds; D043823:Taxoids; D003841:Deoxycytidine; C080625:taxane; D014747:Vinblastine; D000069287:Capecitabine; D000077235:Vinorelbine; D005472:Fluorouracil