Ixabepilone plus capecitabine with capecitabine alone for metastatic breast cancer.
OBJECTIVE
We conducted a systematic review to estimate efficacy and safety of ixabepilone plus capecitabine compared with capecitabine alone for patients of anthracycline- and/or taxane-resistant metastatic breast cancer.


METHODS
PubMed, Cochrane Library, EMBASE, ClinicalTrials.gov and other databases were searched. Randomized controlled trials containing ixabepilone plus capecitabine for anthracycline- and/or taxane-resistant metastatic breast cancer were eligible. Studies were assessed for eligibility and quality, and data were extracted by two independent reviewers. Overall response rates and toxicity were analyzed as dichotomous variables. Overall survival and time to progression data were analyzed as inverse variables. Meta-analyses were carried out by Review Manager 5.0 Software.


RESULTS
This report included two large clinical trials (1973 patients) for patients with metastatic breast cancer resistant to taxanes and resistant to or pretreated with anthracyclines. Ixabepilone plus capecitabine has prolonged the median time to progression, increased overall survival and significantly increased response rates compared with capecitabine alone. Adverse events observed with the combination arm were generally manageable and well tolerated with neutropenia and febrile neutropenia, and peripheral neuropathy, myalgia, diarrhea, stomatitis and hand-foot syndrome were easily controlled.


CONCLUSIONS
Ixabepilone plus capecitabine demonstrated clinical activity with an acceptable safety profile, which seems to be a valid option for patients with anthracycline-pretreated/resistant and taxane-resistant metastatic breast cancer.
Evidence-Based Medicine Center and Second Clinical Medical College, Lanzhou University, Gansu Lanzhou 730000, China. guo19880101@126.com
Lun
L
Li
Jiang
J
Li
Kehu
K
Yang
Jinhui
J
Tian
Tiantian
T
Sun
Wenqin
W
Jia
Peng
P
Zhang
Kang
K
Yi
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy*; D000069287:Capecitabine; D003841:Deoxycytidine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D019008:Drug Resistance, Neoplasm; D034261:Epothilones / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D005472:Fluorouracil / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D016032:Randomized Controlled Trials as Topic
D034261:Epothilones; D003841:Deoxycytidine; D000069287:Capecitabine; C430592:ixabepilone; D005472:Fluorouracil