title: Efficacy and safety of capecitabine-based first-line chemotherapy in advanced or metastatic breast cancer: a meta-analysis of randomised controlled trials.
abstract: 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.
authors.affiliation: Department of Oncology, The First Affiliated Hospital of Henan University of Science and Technology, Luoyang, PR, China.
authors.forename: Weijiao
authors.initials: W
authors.lastname: Yin
authors.affiliation: Department of Respiratory Medicine, The First Affiliated Hospital of Henan University of Science and Technology, Luoyang, PR, China.
authors.forename: Guangsheng
authors.initials: G
authors.lastname: Pei
authors.affiliation: Department of Oncology, The First Affiliated Hospital of Henan University of Science and Technology, Luoyang, PR, China.
authors.forename: Gang
authors.initials: G
authors.lastname: Liu
authors.affiliation: Department of Gynecology, The First Affiliated Hospital of Henan University of Science and Technology, Luoyang, PR, China.
authors.forename: Li
authors.initials: L
authors.lastname: Huang
authors.affiliation: Department of Oncology, The First Affiliated Hospital of Henan University of Science and Technology, Luoyang, PR, China.
authors.forename: Shegan
authors.initials: S
authors.lastname: Gao
authors.affiliation: Department of Oncology, The First Affiliated Hospital of Henan University of Science and Technology, Luoyang, PR, China.
authors.forename: Xiaoshan
authors.initials: X
authors.lastname: Feng
mesh_terms: D000964:Antimetabolites, Antineoplastic / Q000009:adverse effects / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology; D000069287:Capecitabine / Q000009:adverse effects / Q000627:therapeutic use*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
chemical_list: D000964:Antimetabolites, Antineoplastic; D000069287:Capecitabine
keywords: breast cancer; capecitabine; first-line; meta-analysis