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Low-dose capecitabine plus docetaxel as first-line therapy for metastatic breast cancer: phase II results

Michalaki, Vasiliki; Gennatas, Spyridon; Gennatas, Konstantine

doi: 10.1097/CAD.0b013e328327d492

The addition of capecitabine to docetaxel significantly improves overall survival in anthracycline-pretreated metastatic breast cancer. We evaluated a low-dose capecitabinedocetaxel regimen as first-line therapy. Patients who had received adjuvant anthracyclines received docetaxel 75 mg/m2 on day 1 and capecitabine 950 mg/m2 twice daily, days 1–14, every 3 weeks until disease progression or unacceptable toxicity. The primary endpoint was time to progression. Forty-five patients were evaluable (median age 56 years, range 35–75). The response rate was 42%, including two complete responses. Nine patients (20%) attained stable disease. Median time to progression was 8 months and median overall survival was 23 months. Five patients (11%) experienced grade 3 neutropenia but febrile neutropenia was absent. Three patients (7%) experienced grade 3 hand–foot syndrome; there was no significant gastrointestinal toxicity. This capecitabinedocetaxel regimen is an active first-line therapy and appears better tolerated than regimens using a higher capecitabine dose. Data from the randomized trial comparing the registered versus a lower capecitabine dose, both in combination with docetaxel, should definitively answer whether a lower dose provides a better safety profile while maintaining the considerable efficacy of this combination.

Oncology Clinic Department of Surgery, Areteion Hospital, University of Athens, Athens, Greece

Correspondence to Professor Konstantine Gennatas, Oncology Clinic Department of Surgery, Areteion Hospital, University of Athens, Arnis 5, Athens 115 28, Greece

Tel: +30 210 7244758; fax: +30 210 7246878; e-mail:

Received 21 September 2008 Revised form accepted 25 December 2008

© 2009 Lippincott Williams & Wilkins, Inc.