Efficacy and Safety of Capecitabine for Triple-Negative Breast Cancer: A Meta-Analysis

Xueqiong Xun; Qinguang Cao; Pan Hong; Saroj Rai; Yeming Zhou; Ruikang Liu; Huiyong Hu

doi:10.3389/fonc.2022.899423

Efficacy and Safety of Capecitabine for Triple-Negative Breast Cancer: A Meta-Analysis

Front Oncol. 2022 Jul 7:12:899423. doi: 10.3389/fonc.2022.899423. eCollection 2022.

Authors

Xueqiong Xun¹, Qinguang Cao¹, Pan Hong², Saroj Rai^{3

4}, Yeming Zhou⁵, Ruikang Liu⁶, Huiyong Hu¹

Affiliations

¹ Department of Thyroid and Breast Surgery, First People's Hospital of Qujing, Qujing, China.
² Department of Orthopaedic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
³ Department of Orthopaedics and Trauma Surgery, Blue Cross Hospital, Kathmandu, Nepal.
⁴ Department of Orthopaedics and Trauma Surgery, Karama Medical Center, Dubai, United Arab Emirates.
⁵ Basic Medical School, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
⁶ Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Abstract

Background: Triple-negative breast cancer (TNBC) is the most aggressive subtype of breast cancer with limited treatment options and poor prognosis. Capecitabine, as a novel adjuvant chemotherapy for TNBCs, remains controversial. Therefore, we conducted this meta-analysis to assess the efficacy and safety of capecitabine for early-stage TNBCs combined with neo-/adjuvant chemotherapy.

Methods: We searched Medline, Embase, Web of Science, and Cochrane databases updated on Mar 18, 2022 for relevant RCTs. In all, 11 RCTs with 5,175 patients were included. We used hazard ratios (HRs) and odds ratios (ORs) to assess the differences between disease-free survival (DFS), overall survival (OS), and adverse events.

Results: Our study demonstrated significance differences in both DFS and OS (DFS: HR=0.77; 95% CI 0.68-0.86; OS: HR=0.73, 95% CI 0.63-0.85). In subgroup analysis, the lower dosage group showed higher DFS (HR=0.79, 95% CI 0.69-0.91), higher frequency (HR=0.72, 95%CI 0.62-0.83), and adjuvant chemotherapy (HR=0.74, 95% CI 0.65-0.84). However, capecitabine was also associated with a higher risk of diarrhea (OR=3.10, 95% CI 2.32-4.15), hand-foot syndrome (OR=25.79, 95% CI 15.32-43.42), and leukopenia (OR=2.08, 95% CI 1.13-3.84).

Conclusion: The addition of capecitabine to early-stage TNBC patients receiving standard adjuvant chemotherapy showed significant DFS and OS improvement with tolerable adverse events. The lower dosage and higher frequency of capecitabine combined with adjuvant chemotherapy demonstrated a better survival outcome.

Keywords: capecitabine; chemotherapy; meta-analysis; triple-negative breast cancer (TNBC); xeloda.