PMID- 33468087
OWN - NLM
STAT- MEDLINE
DCOM- 20210906
LR  - 20240330
IS  - 1471-2407 (Electronic)
IS  - 1471-2407 (Linking)
VI  - 21
IP  - 1
DP  - 2021 Jan 19
TI  - The role of capecitabine-based neoadjuvant and adjuvant chemotherapy in 
      early-stage triple-negative breast cancer: a systematic review and meta-analysis.
PG  - 78
LID - 10.1186/s12885-021-07791-y [doi]
LID - 78
AB  - BACKGROUND: The role of capecitabine in neoadjuvant and adjuvant chemotherapy for 
      early-stage triple-negative breast cancer (TNBC) is highly controversial. Our 
      meta-analysis was designed to further elucidate the effects of capecitabine on 
      survival in early-stage TNBC patients and its safety. METHODS: PubMed, Embase, 
      and papers presented at several main conferences were searched up to December 19, 
      2019, to investigate capecitabine-based versus capecitabine-free neoadjuvant and 
      adjuvant chemotherapy in TNBC patients. Heterogeneity was assessed using I(2) 
      test, combined with hazard ratios (HRs) and odds ratios (ORs) with 95% confidence 
      intervals (CI) computed for disease-free survival (DFS), overall survival (OS), 
      and over grade 3 adverse events (AEs). RESULTS: A total of 9 randomized clinical 
      trials and 3842 TNBC patients were included. Overall, the combined capecitabine 
      regimens in neoadjuvant and adjuvant chemotherapy showed significantly improved 
      DFS (HR = 0.75; 95% CI, 0.65-0.86; P < 0.001) and OS (HR = 0.63; 95% CI, 
      0.53-0.77; P < 0.001). In subgroup analysis, there were improvements in DFS in 
      the groups with addition of capecitabine (HR = 0.64; 95% CI, 0.53-0.78; 
      P < 0.001), adjuvant chemotherapy (HR = 0.73; 95% CI, 0.63-0.85; P < 0.001), and 
      lymph node positivity (HR = 0.62; 95% CI, 0.44-0.86; P = 0.005). Capecitabine 
      regimens were related to higher risks of diarrhea (OR = 2.88, 95% CI 2.23-3.74, 
      P < 0.001), stomatitis (OR = 2.01, 95% CI 1.53-2.64, P < 0.001) and hand-foot 
      syndrome (OR = 8.67, 95% CI 6.70-11.22, P < 0.001). CONCLUSION: This 
      meta-analysis showed that neoadjuvant and adjuvant chemotherapy combined with 
      capecitabine significantly improved both DFS and OS in early-stage TNBC patients 
      with tolerable AEs. There were benefits to DFS in the groups with the addition of 
      capecitabine, adjuvant chemotherapy, and lymph node positivity.
FAU - Huo, Xingfa
AU  - Huo X
AD  - Breast Disease Diagnosis and Treatment Center of Affiliated Hospital of Qinghai 
      University & Affiliated Cancer Hospital of Qinghai University, Xining, 810000, 
      China.
FAU - Li, Jinming
AU  - Li J
AD  - Breast Disease Diagnosis and Treatment Center of Affiliated Hospital of Qinghai 
      University & Affiliated Cancer Hospital of Qinghai University, Xining, 810000, 
      China.
FAU - Zhao, Fuxing
AU  - Zhao F
AD  - Breast Disease Diagnosis and Treatment Center of Affiliated Hospital of Qinghai 
      University & Affiliated Cancer Hospital of Qinghai University, Xining, 810000, 
      China.
FAU - Ren, Dengfeng
AU  - Ren D
AD  - Breast Disease Diagnosis and Treatment Center of Affiliated Hospital of Qinghai 
      University & Affiliated Cancer Hospital of Qinghai University, Xining, 810000, 
      China.
FAU - Ahmad, Raees
AU  - Ahmad R
AD  - Breast Disease Diagnosis and Treatment Center of Affiliated Hospital of Qinghai 
      University & Affiliated Cancer Hospital of Qinghai University, Xining, 810000, 
      China.
FAU - Yuan, Xinyue
AU  - Yuan X
AD  - Breast Disease Diagnosis and Treatment Center of Affiliated Hospital of Qinghai 
      University & Affiliated Cancer Hospital of Qinghai University, Xining, 810000, 
      China.
FAU - Du, Feng
AU  - Du F
AD  - Peking University Cancer Hospital and Institute, Beijing, 100142, China.
FAU - Zhao, Jiuda
AU  - Zhao J
AD  - Breast Disease Diagnosis and Treatment Center of Affiliated Hospital of Qinghai 
      University & Affiliated Cancer Hospital of Qinghai University, Xining, 810000, 
      China. jiudazhao@126.com.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20210119
PL  - England
TA  - BMC Cancer
JT  - BMC cancer
JID - 100967800
RN  - 6804DJ8Z9U (Capecitabine)
SB  - IM
MH  - Antineoplastic Combined Chemotherapy Protocols/*therapeutic use
MH  - Breast/pathology/surgery
MH  - Capecitabine/*therapeutic use
MH  - Chemotherapy, Adjuvant/methods
MH  - Disease-Free Survival
MH  - Female
MH  - Humans
MH  - *Mastectomy
MH  - Neoadjuvant Therapy/*methods
MH  - Neoplasm Staging
MH  - Proportional Hazards Models
MH  - Triple Negative Breast Neoplasms/diagnosis/mortality/pathology/*therapy
PMC - PMC7816481
OTO - NOTNLM
OT  - Capecitabine
OT  - Neo/adjuvant chemotherapy
OT  - Survival
OT  - Triple-negative breast cancer
COIS- The authors have declared no conflicts of interest.
EDAT- 2021/01/21 06:00
MHDA- 2021/09/07 06:00
PMCR- 2021/01/19
CRDT- 2021/01/20 05:36
PHST- 2020/02/25 00:00 [received]
PHST- 2021/01/05 00:00 [accepted]
PHST- 2021/01/20 05:36 [entrez]
PHST- 2021/01/21 06:00 [pubmed]
PHST- 2021/09/07 06:00 [medline]
PHST- 2021/01/19 00:00 [pmc-release]
AID - 10.1186/s12885-021-07791-y [pii]
AID - 7791 [pii]
AID - 10.1186/s12885-021-07791-y [doi]
PST - epublish
SO  - BMC Cancer. 2021 Jan 19;21(1):78. doi: 10.1186/s12885-021-07791-y.