Pegylated liposomal doxorubicin and capecitabine are effective first line therapies for metastatic breast cancer

This study investigated the safety and effectiveness of using liposomal pegylated doxorubicin (PLD, Doxil) versus capecitabine (Xeloda) as initial treatment for metastatic breast cancer. The authors concluded that both treatments were safe and effective.

Metastatic breast cancer is a cancer that has spread to other parts of the body. Effective chemotherapy treatment can increase survival and improve quality of life. Single agent chemotherapy (using a single drug at a time) has lower toxicity (negative side effects) and similar effectiveness to combination therapy (a combination of two or more drugs). PLD and capecitabine have been used effectively in single therapy. It is not clear whether one of these treatments is more effective in metastatic breast cancer.

This study compared the safety and effectiveness of these two treatments. 210 patients were randomly assigned to treatment with either PLD or capecitabine. Patients were treated until the disease progressed or they experienced severe negative side effects. Patients were followed every six months after treatment ended.

There was no difference in the time until the disease progressed between the PLD and capecitabine treated patients. The average was 6 months in both groups. There was no significant difference in overall survival (time from treatment until death from any cause).

The most common negative effects associated with PLD were hand-foot syndrome (66%, redness and swelling of the hands and feet), stomach inflammation (40%), and fatigue (54%). The most common negative effects associated with capecitabine were hand-foot syndrome (67%), fatigue (54%), and diarrhea (43%). Patients treated with capecitabine experienced more serious adverse events overall compared to patients treated with PLD.

The overall number of heart problems did not differ between the treatments. Among the patients who were previously exposed to anthracycline chemotherapy (such as doxorubicin), those treated with capecitabine (18%) were more likely to develop heart problems than those treated with PLD (8%).

This study concluded that PLD and capecitabine are both effective and relatively well tolerated initial treatments for metastatic breast cancer. 

The study does not examine the patients response in relation to their age or if they suffer from other diseases as well as metastatic breast cancer. Only women with breast cancer were included in this trial.