Oral Capecitabine-Vinorelbine is Associated with Longer Overall Survival When Compared to Single-Agent Capecitabine in Patients with Hormone Receptor-Positive Advanced Breast Cancer

• Main Authors: Claudio Vernieri, Michele Prisciandaro, Federico Nichetti, Riccardo Lobefaro, Giorgia Peverelli, Francesca Ligorio, Emma Zattarin, Maria Silvia Cona, Pierangela Sepe, Francesca Corti, Sara Manglaviti, Marta Brambilla, Barbara Re, Antonino Belfiore, Giancarlo Pruneri, Luigi Celio, Gabriella Mariani, Giulia Valeria Bianchi, Licia Rivoltini, Giuseppe Capri, Filippo de Braud
• Format: Article
• Language: English
• Published: MDPI AG 2020-03-01
• Series: Cancers
• Subjects: advanced breast cancer; chemotherapy; capecitabine; vinorelbine; hormone receptor-positive breast cancer; triple-negative breast cancer; progression-free survival; overall survival; adverse events
• Online Access: https://www.mdpi.com/2072-6694/12/3/617

<em>Background</em>: Single-agent capecitabine (C) is a moderately effective chemotherapeutic compound in the treatment of patients with HER2-negative metastatic breast cancer (mBC). The capecitabine-vinorelbine (CV) combination is also used due to a good tolerability profile, but no studies have demonstrated its superiority over single-agent C.<em> Methods</em>: We conducted a retrospective analysis to compare overall response rate (ORR), progression-free survival (PFS), overall survival (OS) and incidence of adverse events (AEs) in patients with HER2-negative mBC treated with CV vs. single-agent C. <em>Results:</em> Out of 290 patients included in this study, 127 (43.8%) received single-agent C, while 163 (56.2%) patients were treated with CV. Median PFS was similar in patients treated with single-agent C or CV, while CV was associated with significantly longer OS in patients with hormone receptor-positive (HR+) BC. This OS advantage was confirmed at multivariable analysis also after propensity score-based matching of patients according to relevant clinical or tumor characteristics. When compared with single-agent C, CV was associated with higher incidence of G3/G4 and any-grade nausea/vomiting, diarrhea and increased transaminases. <em>Conclusions</em>: While prospective studies are needed to confirm our findings, the potential OS advantage of CV over single-agent C in HR+ mBC patients must be weighed against a significantly higher incidence of AEs.