Safety and Efficacy of Combined Metronomic Capecitabine with Aromatase Inhibitors for Patients with Newly Diagnosed Metastatic Hormone Positive, HER2 Negative Breast Cancer


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Badr Abdelmaksoud1,Mostafa Toam2
1faculty of medicine, zagazig university,2zagazig university



Metasatic breast cancer is considard to be a treatable  but  non curable disease  with median survival of 18-24 months, and so, the aim of treatment of such cases is optimization of both length and quality of life. Hormonal therapy is the corner stone for teatment of minimally symtomatic cases with positive hormonal receptors although addition of low dose chemotherapy to hormonal therapy appeared to have favorable outcome The aim is to evaluate and assess the efficacy and tolerability of combined metronomic capecitabine with aromatase inhibitors for patients with newly diagnosed metastatic hormone positive HER2 negative breast cancer.


Forty-one women with confirmed diagnosis of metastatic hormone receptor-positive, HER2 negative breast cancer were sbjected to oral metronomic capecitabine, 500mg/m2 per-oral twice daily combined with an aromatase inhibitor . The cycle is repeated every twenty one dayes and continued for stable and responsive cases until; disease progression, intolerable toxicities or patient refusal to continue treatment


The mean age was 52.89 years (28-69), there were ten patients (24.4%) pre-menopausl, five (12.2%) were peri-menopausal and twenty six (63.4%) were post-menopausal, twenty three patients (56.1%) had single organ metastasis while others had multiple organs metastasis. After a median follow-up of 24 months (9-50), in which a median of 15 months of treatment were completed, the median time to progression (TTP) was 15 months (12.6-17.3) and the median overall survival was 37 months (23.6-50.4). Generaly the treatment was tolerated with less than 10% grade 3 toxcicities.


Combination of metronomic capcitabine and aromaotase inhibitors appeared to be safe and has encouraging results in advanced hormone receptor positive, HER2 negative, breast cancer