Cancer medicine · 2026
Real-World Efficacy of Metronomic Chemotherapy in Advanced Breast Cancer Across Molecular Subtypes.
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Zhou Hanxing, Chen Linmin, Lu Qianyi, Wu Huailiang, Jiang Kuikui, Xu Fei, Wang Shusen
Аннотация
OBJECTIVE: Metronomic chemotherapy (mCHT) is widely used in the treatment of breast cancer due to its low toxicity and convenience. However, there remain real-world studies with satisfactory samples focusing on mCHT in advanced breast cancer.
METHODS: Enrolled patients were assigned into capecitabine-based (X-based) group and other mCHT group. Data on baseline characteristics, treatment regimens, and outcomes were extracted from medical records. Kaplan-Meier estimates of progression-free survival (PFS) and overall survival (OS) were analyzed.
RESULTS: Totally, 597 patients were included with median follow-up time of 35.9 months. The median PFS for X-base group was significantly higher than that in other mCHT group (8.9 vs. 5.9 months, p = 0.004). As salvage therapy, the X-based group showed significantly higher PFS and OS than the other mCHT group in patients with HR + HER2- breast cancer (p < 0.001 and p = 0.011), especially in those combined with endocrine therapy (ET). Multivariate Cox analysis revealed that additional ET could reduce the disease progression and death risks (HR = 0.60, 95% CI: 0.44-0.81; HR = 0.66, 95% CI: 0.47-0.93). In HER2+ and TNBC populations, the median PFS was higher when used as maintenance therapy compared to salvage therapy (16.0 vs. 7.0 months, p < 0.001; 11.0 vs. 5.0 months, p = 0.030).
CONCLUSION: As salvage therapy, mCHT demonstrated significant efficacy advantages in the X-based group compared to the other mCHT group in patients with HR + HER2- breast cancer, especially in those combined with ET. For HER2+ and TNBC patients, mCHT is recommended as maintenance therapy.
METHODS: Enrolled patients were assigned into capecitabine-based (X-based) group and other mCHT group. Data on baseline characteristics, treatment regimens, and outcomes were extracted from medical records. Kaplan-Meier estimates of progression-free survival (PFS) and overall survival (OS) were analyzed.
RESULTS: Totally, 597 patients were included with median follow-up time of 35.9 months. The median PFS for X-base group was significantly higher than that in other mCHT group (8.9 vs. 5.9 months, p = 0.004). As salvage therapy, the X-based group showed significantly higher PFS and OS than the other mCHT group in patients with HR + HER2- breast cancer (p < 0.001 and p = 0.011), especially in those combined with endocrine therapy (ET). Multivariate Cox analysis revealed that additional ET could reduce the disease progression and death risks (HR = 0.60, 95% CI: 0.44-0.81; HR = 0.66, 95% CI: 0.47-0.93). In HER2+ and TNBC populations, the median PFS was higher when used as maintenance therapy compared to salvage therapy (16.0 vs. 7.0 months, p < 0.001; 11.0 vs. 5.0 months, p = 0.030).
CONCLUSION: As salvage therapy, mCHT demonstrated significant efficacy advantages in the X-based group compared to the other mCHT group in patients with HR + HER2- breast cancer, especially in those combined with ET. For HER2+ and TNBC patients, mCHT is recommended as maintenance therapy.
Предметные рубрики MeSH
Administration, MetronomicBreast NeoplasmsAntineoplastic Combined Chemotherapy ProtocolsCapecitabineKaplan-Meier EstimateProgression-Free SurvivalFollow-Up StudiesErb-b2 Receptor Tyrosine KinasesMaintenance ChemotherapySalvage TherapyRetrospective StudiesNeoplasm StagingHumansFemaleAdultMiddle AgedPrognosisAntimetabolites, Antineoplastic