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
A promising target for kidney fibrosis
21.04.2017 | Brigham and Women's Hospital
Stem cell transplants: activating signal paths may protect from graft-versus-host disease
20.04.2017 | Technische Universität München
More and more automobile companies are focusing on body parts made of carbon fiber reinforced plastics (CFRP). However, manufacturing and repair costs must be further reduced in order to make CFRP more economical in use. Together with the Volkswagen AG and five other partners in the project HolQueSt 3D, the Laser Zentrum Hannover e.V. (LZH) has developed laser processes for the automatic trimming, drilling and repair of three-dimensional components.
Automated manufacturing processes are the basis for ultimately establishing the series production of CFRP components. In the project HolQueSt 3D, the LZH has...
Reflecting the structure of composites found in nature and the ancient world, researchers at the University of Illinois at Urbana-Champaign have synthesized thin carbon nanotube (CNT) textiles that exhibit both high electrical conductivity and a level of toughness that is about fifty times higher than copper films, currently used in electronics.
"The structural robustness of thin metal films has significant importance for the reliable operation of smart skin and flexible electronics including...
The nearby, giant radio galaxy M87 hosts a supermassive black hole (BH) and is well-known for its bright jet dominating the spectrum over ten orders of magnitude in frequency. Due to its proximity, jet prominence, and the large black hole mass, M87 is the best laboratory for investigating the formation, acceleration, and collimation of relativistic jets. A research team led by Silke Britzen from the Max Planck Institute for Radio Astronomy in Bonn, Germany, has found strong indication for turbulent processes connecting the accretion disk and the jet of that galaxy providing insights into the longstanding problem of the origin of astrophysical jets.
Supermassive black holes form some of the most enigmatic phenomena in astrophysics. Their enormous energy output is supposed to be generated by the...
The probability to find a certain number of photons inside a laser pulse usually corresponds to a classical distribution of independent events, the so-called...
Microprocessors based on atomically thin materials hold the promise of the evolution of traditional processors as well as new applications in the field of flexible electronics. Now, a TU Wien research team led by Thomas Müller has made a breakthrough in this field as part of an ongoing research project.
Two-dimensional materials, or 2D materials for short, are extremely versatile, although – or often more precisely because – they are made up of just one or a...
20.04.2017 | Event News
18.04.2017 | Event News
03.04.2017 | Event News
25.04.2017 | Physics and Astronomy
25.04.2017 | Materials Sciences
25.04.2017 | Life Sciences