Adjuvant Capecitabine for Breast Cancer after Preoperative Chemotherapy

• Published in: The New England journal of medicine Vol. 376; no. 22; pp. 2147 - 2159
• Main Authors: Masuda, Norikazu, Lee, Soo-Jung, Ohtani, Shoichiro, Im, Young-Hyuck, Lee, Eun-Sook, Yokota, Isao, Kuroi, Katsumasa, Im, Seock-Ah, Park, Byeong-Woo, Kim, Sung-Bae, Yanagita, Yasuhiro, Ohno, Shinji, Takao, Shintaro, Aogi, Kenjiro, Iwata, Hiroji, Jeong, Joon, Kim, Aeree, Park, Kyong-Hwa, Sasano, Hironobu, Ohashi, Yasuo, Toi, Masakazu
• Format: Journal Article
• Language: English
• Published: United States Massachusetts Medical Society 01.06.2017
• Subjects: Adjuvants; Adult; Aged; Anthracycline; Antimetabolites, Antineoplastic - adverse effects; Antimetabolites, Antineoplastic - therapeutic use; Breast cancer; Breast Neoplasms - drug therapy; Breast Neoplasms - mortality; Breast Neoplasms - surgery; Capecitabine - adverse effects; Capecitabine - therapeutic use; Chemotherapy; Chemotherapy, Adjuvant - adverse effects; Clinical trials; Death; Epidermal growth factor; ErbB-2 protein; Feet; Female; Hand-Foot Syndrome - etiology; Humans; Invasiveness; Medical prognosis; Medical research; Middle Aged; Neoadjuvant Therapy; Neoplasm Staging; Preoperative Care; Prognosis; Receptor, ErbB-2; Survival; Survival Analysis; Triple Negative Breast Neoplasms - drug therapy; Triple Negative Breast Neoplasms - mortality
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJMoa1612645

Patients who complete neoadjuvant chemotherapy for breast cancer without a pathological complete response have a high risk of relapse. A randomized trial comparing capecitabine with no additional adjuvant therapy showed that capecitabine prolonged disease-free and overall survival. Patients who have residual invasive breast cancer after the receipt of neoadjuvant chemotherapy have a high risk of relapse. 1 The rate of complete response as assessed on pathological testing (hereafter, pathological complete response) ranges from 13 to 22% among patients with human epidermal growth factor receptor 2 (HER2)–negative primary breast cancer. 1 Patients who do not have a pathological complete response after the receipt of neoadjuvant taxane and anthracycline chemotherapy have a 20 to 30% risk of relapse. 2 Patients with HER2-negative cancer who receive neoadjuvant chemotherapy often receive postoperative radiation therapy, whereas endocrine therapy is administered to patients with hormone-receptor–positive disease . . .