Safety and efficacy of moderate-dose capecitabine as first-line therapy in metastatic breast cancer

Breast cancer is the most frequent malignant disease in women. Although fewer than 10% of patients show metastatic disease at diagnosis, approximately one in every five patients will relapse. Great biologic heterogeneity in breast cancer is well known due to the implementation of newer molecular technologies. This knowledge has led to a better development and selection of new therapies. Regimens based on taxanes and anthracyclines are the classical treatments accepted as first-line therapy. Capecitabine is an orally administered systemic prodrug of 5'-deoxy-5-fluorouridine, which is converted to 5-fluorouracil with a favorable but different toxicity profile to other cytotoxic drugs. However, a considerable proportion of patients need to suspend or reduce the dose of capecitabine when it is administrated at the registered dose of 1250 mg/m(2) twice daily 14 days every 21 owing to adverse events. In this study, Kaufmann et al. show the activity and safety of capecitabina at a lower dose (1000 mg/m(2) twice daily) at first-line therapy in HER2-negative metastatic breast cancer.