Professor Gunter von Minckwitz, Chairman of the German Breast Group, Neu-Isenberg, Germany, and his team set out to look at the use of the combination in early breast cancer. “We recruited 1510 patients with previously untreated primary tumours,” he said. “Each received the normal preoperative treatment of four cycles of epirubicin and cyclophosphamide. We then randomised them to either four cycles of docetaxel alone, four cycles of simultaneous docetaxel and capecitabine, or four cycles of docetaxel followed by four cycles of capecitabine. If capecitabine were to improve outcomes, we wanted to see how best to use it – simultaneously or in sequence.”
The scientists planned to study the pathologic response at surgery – the way, if any, in which the tumour had reacted to the administration of the chemotherapy drug.
“However, we found no difference in efficacy between the three arms of the trial with regard to pathologic response, clinical response, and rate of breast conservations,” said Professor von Minckwitz. “The overall rate of pathologic complete responses (pCRs) – no cancer in the breast or lymph nodes – was 29.7%.”
Nor did the length of treatment appear to make a statistically significant difference. What the scientists did find was that the addition of capecitabine to the chemotherapy regime produced more non-haematological toxicities – for example hand-foot syndrome, a skin reaction that appears on the palms of the hands and soles of the feet, and which can be very painful if untreated. They also found increased rates of nail changes, stomatitis (inflammation of the mucous lining the mouth and throat), and diarrhoea.
The scientists now intend to follow up their work by correlating the response at the time of surgery with the long-term outcomes for patients. “Although it is the best indication we have at present, it is still uncertain whether pCR is a reliable predictor of long-term activity,” said Professor von Minckwitz.
Given the lack of extra efficacy of adding capecitabine to docetaxel, and the additional toxicities that it produces, the scientists say that they would not recommend using it as preoperative treatment in early breast cancer. “Prolongation of chemotherapy also has the effect of reducing patient compliance, so, given all these factors we would recommend staying with current standard treatments – epirubicin and cyclophosphamide followed by a taxane, or TAC, another commonly used three-drug combination of docetaxel, doxorubicin and cyclophosphamide,” said Professor von Minckwitz.
Mary Rice | alfa
Resolving the mystery of preeclampsia
21.10.2016 | Universitätsklinikum Magdeburg
New potential cancer treatment using microwaves to target deep tumors
12.10.2016 | University of Texas at Arlington
Researchers from the Institute for Quantum Computing (IQC) at the University of Waterloo led the development of a new extensible wiring technique capable of controlling superconducting quantum bits, representing a significant step towards to the realization of a scalable quantum computer.
"The quantum socket is a wiring method that uses three-dimensional wires based on spring-loaded pins to address individual qubits," said Jeremy Béjanin, a PhD...
In a paper in Scientific Reports, a research team at Worcester Polytechnic Institute describes a novel light-activated phenomenon that could become the basis for applications as diverse as microscopic robotic grippers and more efficient solar cells.
A research team at Worcester Polytechnic Institute (WPI) has developed a revolutionary, light-activated semiconductor nanocomposite material that can be used...
By forcefully embedding two silicon atoms in a diamond matrix, Sandia researchers have demonstrated for the first time on a single chip all the components needed to create a quantum bridge to link quantum computers together.
"People have already built small quantum computers," says Sandia researcher Ryan Camacho. "Maybe the first useful one won't be a single giant quantum computer...
COMPAMED has become the leading international marketplace for suppliers of medical manufacturing. The trade fair, which takes place every November and is co-located to MEDICA in Dusseldorf, has been steadily growing over the past years and shows that medical technology remains a rapidly growing market.
In 2016, the joint pavilion by the IVAM Microtechnology Network, the Product Market “High-tech for Medical Devices”, will be located in Hall 8a again and will...
'Ferroelectric' materials can switch between different states of electrical polarization in response to an external electric field. This flexibility means they show promise for many applications, for example in electronic devices and computer memory. Current ferroelectric materials are highly valued for their thermal and chemical stability and rapid electro-mechanical responses, but creating a material that is scalable down to the tiny sizes needed for technologies like silicon-based semiconductors (Si-based CMOS) has proven challenging.
Now, Hiroshi Funakubo and co-workers at the Tokyo Institute of Technology, in collaboration with researchers across Japan, have conducted experiments to...
14.10.2016 | Event News
14.10.2016 | Event News
12.10.2016 | Event News
21.10.2016 | Health and Medicine
21.10.2016 | Information Technology
21.10.2016 | Materials Sciences