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Adjuvant addition of capecitabine to early-stage triple-negative breast cancer patients receiving standard chemotherapy: a meta-analysis

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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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Authors and Affiliations

  1. Department of Breast Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan, Dongcheng District, Beijing, 100730, People’s Republic of China

    Yan Li, Yidong Zhou, Feng Mao, Yan Lin, Xiaohui Zhang, Songjie Shen & Qiang Sun

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  1. Yan Li
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  2. Yidong Zhou
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  3. Feng Mao
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  4. Yan Lin
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  5. Xiaohui Zhang
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  7. Qiang Sun
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Contributions

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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Correspondence to Qiang Sun.

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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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