Metronomic capecitabine in metastatic triple negative breast cancer.

Abstract

Objective: To evaluate the efficacy and safety of metronomic capecitabine in patients with metastatic TNBC (mTNBC), with progression free survival (PFS) as primary end point and toxicity profile as secondary endpoint. Study Design: Retrospective study. Setting: Department of Radiotherapy, Quaid e Azam Medical College, Bahawalpur, Pakistan. Period: 1st January 2022 to 30^th October 2025. Methods: The study included patients with mTNBC of any age who were metastatic at presentation. All patients received first-line chemotherapy, or subsequently went on to receive the second-line chemotherapy. Capecitabine at a dose of 500 mg twice daily was administered to patients with stable disease after initial chemotherapy. Patients were asked to follow up every 4 weeks and thorough clinical examination was performed at each follow up. Results: Out of 643 breast cancer patients, 117 (18.2%) had stage IV disease, with 47 (40.1%) having mTNBC. The median age was 44 years. There were 33 (70.2%) patients who achieved stable disease and started metronomic capecitabine following initial chemotherapy. Among these 33 patients, 24 (72.7%) had stable disease while remaining 9 (27.3%) experienced disease progression. The most common toxicities were mild nausea and vomiting, noted in 9 (27.2%), grade 1 diarrhea 4 (12%), grade 1 mucositis 3 (9.1%), and grade 1 myelosuppression 4 (12.4%). Conclusion: Metronomic capecitabine was an effective and well-tolerated treatment option for patients with mTNBC, particularly in the short term.