Does the Dose of Standard Adjuvant Chemotherapy Affect the Triple-negative Breast Cancer Benefit from Extended Capecitabine Metronomic Therapy? An Exploratory Analysis of the SYSUCC-001 Trial

Ying Chen, Wen Xia Li, Jia Hua Wu, Geng Hang Chen, Chun Min Yang, Hai Lu, Xi Wang, Shu Sen Wang, Heng Huang, Li Cai, Li Zhao, Rou Jun Peng, Ying Lin, Jun Tang, Jian Zeng, Le Hong Zhang, Yong Li Ke, Xian Ming Wang, Xin Mei Liu, An Qin ZhangFei Xu, Xi Wen Bi, Jia Jia Huang, Ji Bin Li, Dan Mei Pang, Cong Xue, Yan Xia Shi, Zhen Yu He, Huan Xin Lin, Xin An, Wen Xia, Ye Cao, Ying Guo, Ruo Xi Hong, Kui Kui Jiang, Yong Yi Zhong, Ge Zhang, Piyawan Tienchaiananda, Masahiro Oikawa, Zhong Yu Yuan*, Qian Jun Chen*

*Corresponding author for this work

Research output: Contribution to journalJournal articlepeer-review

2 Citations (Scopus)

Abstract

Purpose: Results from studies of extended capecitabine after the standard adjuvant chemotherapy in early stage triple-negative breast cancer (TNBC) were inconsistent, and only low-dose capecitabine from the SYSUCC-001 trial improved disease-free survival (DFS). Adjustment of the conventional adjuvant chemotherapy doses affect the prognosis and may affect the efficacy of subsequent treatments. This study investigated whether the survival benefit of the SYSUCC-001 trial was affected by dose adjustment of the standard adjuvant chemotherapy or not.

Patients and Methods: We reviewed the adjuvant chemotherapy regimens before the extended capecitabine in the SYSUCC-001 trial. Patients were classified into “consistent” (standard acceptable dose) and “inconsistent” (doses lower than acceptable dose) dose based on the minimum acceptable dose range in the landmark clinical trials. Cox proportional hazards model was used to investigate the impact of dose on the survival outcomes.

Results: All 434 patients in SYSUCC-001 trial were enrolled in this study. Most of patients administered the anthracycline-taxane regimen accounted for 88.94%. Among patients in the “inconsistent” dose, 60.8% and 47% received lower doses of anthracycline and taxane separately. In the observation group, the “inconsistent” dose of anthracycline and taxane did not affect DFS compared with the “consistent” dose. Moreover, in the capecitabine group, the “inconsistent” anthracycline dose did not affect DFS compared with the “consistent” dose. However, patients with “consistent” taxane doses benefited significantly from extended capecitabine (P=0.014). The sufficient dose of adjuvant taxane had a positive effect of extended capecitabine (hazard ratio [HR] 2.04; 95% confidence interval [CI] 1.02 to 4.06).

Conclusion: This study found the dose reduction of adjuvant taxane might negatively impact the efficacy of capecitabine. Therefore, the reduction of anthracycline dose over paclitaxel should be given priority during conventional adjuvant chemotherapy, if patients need dose reduction and plan for extended capecitabine.
Original languageEnglish
Pages (from-to)223-231
Number of pages9
JournalBreast Cancer: Targets and Therapy
Volume16
DOIs
Publication statusPublished - 12 Apr 2024

Scopus Subject Areas

  • Oncology

User-Defined Keywords

  • adjuvant chemotherapy
  • capecitabine
  • SYSUCC-001
  • triple-negative breast cancer
  • TNBC

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