Standard adjuvant chemotherapy versus capecitabine: longer follow up results in older breast cancer patients

This study aimed to investigate the outcomes of standard adjuvant chemotherapy versus capecitabine (Xeloda) in older patients with breast cancer after 10 years.  

This study concluded that with longer follow up, outcomes remained superior with standard adjuvant chemotherapy.  

The number of older women with breast cancer (BC) that take part in clinical trials is limited. In a previous study results were reported after a median follow up of 2.4 years. Standard adjuvant chemotherapy (SAC) showed significant improvements in recurrence-free survival (RFS) and overall survival (OS) compared with capecitabine. SAC is a treatment used after surgery for BC. It is used to prevent recurrence of the disease. RFS is the period in which the cancer does not return. Capecitabine is a chemotherapy used to treat BC. 

It was not known what the outcomes would be for patients with breast cancer over the age of 65 after a longer follow up period.  

This study involved 633 patients aged 65 or older with early BC. One group received standard adjuvant chemotherapy (SAC) and the other group received capecitabine. The main outcome was RFS. This study provided updated results at a median follow-up of 11.4 years. 

RFS remained significantly longer for patients treated with SAC when compared to those who received capecitabine. At 10 years, the RFS rate for patients in the SAC group was 56% compared to 50% for those in the capecitabine group.  

At 10 years, the BC specific survival rate was 88% for the SAC group compared to 82% for the capecitabine group. At 10 years, the overall survival rate was 62% for the SAC group compared to 56% for the capecitabine group.  

With longer follow-up, SAC remained better to capecitabine among hormone receptor-negative (HR-) patients but not among hormone receptor-positive (HR+) patients. Second cancers occurred in 14.1% of patients. 

This study concluded that with longer follow up, RFS remained superior for SAC compared to capecitabine especially in patients with hormone receptor-negative disease.