Capecitabine and vinorelbine in metastatic breast cancer
MetadataShow full item record
Background - As anthracyclines and taxanes are frequently used in the adjuvant and first-line metastatic settings, capecitabine and vinorelbine are frequently used as monotherapy and in combination for metastatic breast cancer (MBC). In the absence of comparative, phase III data, retrospective analyses and cross-trial comparisons provide the only indication of the relative efficacy of these options. Methods - We reviewed studies evaluating the 2 agents alone or in combination in MBC. Results - We identified 6 capecitabine and 2 vinorelbine phase III trials, numerous phase II monotherapy studies and 35 phase I/II studies exploring capecitabine–vinorelbine combination therapy (1 with trastuzumab in HER2-positive MBC). Conclusion - For monotherapy, the limited, retrospective comparative evidence supported by consistent prospective data suggests that capecitabine is more effective than vinorelbine. Comorbidities, organ function tolerability, tumour biology and patient characteristics should also inform treatment choice. If combination therapy is deemed clinically appropriate, intravenous vinorelbine with capecitabine may be considered, potentially improving efficacy compared with monotherapy, but at the cost of increased toxicity. Randomised evaluation versus capecitabine monotherapy is ongoing. In contrast, cross-trial comparison suggests that addition of oral vinorelbine to capecitabine adds haematological toxicity without apparently improving efficacy in pretreated MBC. Data from small, single-arm, phase II studies in the first-line setting are more encouraging. In summary, the strongest clinical data support capecitabine monotherapy in the majority of patients. In certain populations, a capecitabine–vinorelbine combination may be appropriate but requires further validation in randomised trials.
Showing items related by title, author, creator and subject.
Phase II study of a triple combination of oral vinorelbine, capecitabine and trastuzumab as first-line treatment in HER2-positive metastatic breast cancerChan, Arlene; Conte, P.; Petruzelka, L.; Tubiana-Mathieu, N.; Ganju, V.; Llombart, A.; Espie, M.; Majois, F.; Gil, M.; Vaissiere, N.; Villanova, G. (2013)Chemotherapy plus trastuzumab is the standard first-line treatment for Human Epidermal Receptor 2-positive (HER2-positive) metastatic breast cancer. The aim of this international phase II trial was to determine the efficacy ...
Final Results of the Randomized Phase II NorCap-CA223 Trial Comparing First-Line All-Oral Versus Taxane-Based Chemotherapy for HER2-Negative Metastatic Breast CancerCinieri, S.; Chan, Arlene; Altundag, K.; Vandebroek, A.; Tubiana-Mathieu, N.; Barnadas, A.; Dodyk, P.; Lazzarelli, S.; Botha, M.; Rauch, D.; Villanova, G.; Coskun, U. (2017)© 2016 Elsevier Inc.Background: The purpose of this study was to evaluate the efficacy of 3 first-line chemotherapy combination regimens for HER2-negative metastatic breast cancer (mBC). Patients and Methods: In this ...
Phase II, open-label trial of lapatinib and vinorelbine in women with previously treated HER2-positive metastatic breast cancerChan, Arlene; Shannon, C.; De Boer, R.; Baron-Hay, S.; Redfern, A.; Bauwens, A.; Craft, P.; Webb, S.; Townsend, A.; Kotasek, D. (2014)Aim: To evaluate the efficacy and tolerability of lapatinib (L) and intravenous vinorelbine (V) in patients with metastatic HER2-positive breast cancer who have previously received two lines of anti-HER2 therapy (i.e. ...